Open Access
CC BY-NC-ND 4.0 · Sleep Sci 2024; 17(S 01): S1-S89
DOI: 10.1055/s-0045-1811822
Sleep Science Supplement 2024

Sleep Abnormalities in Stroke: a Case Report

Authors

  • Beatriz Cristina Pimenta

    1   Instituto de Medicina Física e Reabilitação IMREA, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

  • Barbara Khonangz Parise

    1   Instituto de Medicina Física e Reabilitação IMREA, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

  • Arturo Forner-Cordero

    2   Departamento de Mecatrônica e Sistemas Mecânicos, Escola Politécnica, Universidade de São Paulo, São Paulo, SP, Brazil

  • Antenor Bispo dos Santos Silva

    1   Instituto de Medicina Física e Reabilitação IMREA, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

  • Andre Luis da Silva

    1   Instituto de Medicina Física e Reabilitação IMREA, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

  • Linamara Rizzo Battistella

    3   Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil

  • Marta Imamura

    3   Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Keywords

sleep - stroke - sleep hygiene - actigraphy

Introduction: Sleep disorders are highly prevalent in stroke patients, compromising their functional outcome and quality of life.

Objective: To describe the systematic evaluation and management of sleep disturbances in a post-stroke patient during his in-patient multidisciplinary rehabilitation program.

Methods: A 56-year male patient suffered the first episode of a nucleocapsular ischemic stroke on 06/22/2023. He presented with hypertension, dyslipidemia and type 2 diabetes. During the in-patient rehabilitation, he underwent a systematic sleep assessment including Epworth daytime sleepiness (EDS) Pittsburgh scales and objective sleep rhythm measurements provided by a wrist actigraphy (ActTrust2™, Condor Instruments, Brazil) for 13 days. Daily sessions of personalized sleep hygiene were delivered by the nursing team to establish regular sleep, reduce naps during week. Shoulder pain was controlled by the medical team.

Results: EDS (7/24) and Pittsburg (8/21) scales did not reveal sleep disturbances. Actigraphy assessment demonstrated a dysregulated sleep pattern, characterized by 4/5 episodes of daytime naps of ± 50 minutes during the day, in addition to frequent awakenings and an average total sleep time (TST) of 7h55min. After interventions, actigraphy measures demonstrated a standardization of bedtime and wake-up times, a reduction in daytime naps, increased TST to 8h43min, and fewer awakenings. No difference was observed in sleep onset latency. Objective sleep measures alerted the patient to keep the sleep hygiene protocol, even after hospital discharge.

Conclusion: Objective sleep abnormalities obtained by an actigraphy could guide a personalized sleep hygiene intervention. Self-report scales did not capture sleep disturbances in this stroke patient.


No conflict of interest has been declared by the author(s).

Publication History

Article published online:
16 September 2025

© 2025. Brazilian Sleep Academy. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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