Sleep quality in stroke patients receiving botulinum toxin treatment for spasticity

Aim: Botulinum toxin (BoNT) is widely used in the treatment of stroke-related spasticity.Sleep disturbances are often observed as a comorbidity or complication in stroke patients.In light of the data linking spasticity with sleep disorders, this study aimed to evaluate whether spasticity treatment with BoNT improved sleep quality, quality of life, and anxiety levels in stroke patients.Materials and Methods: This observational, cross-sectional study included 38 hemiplegic patients with focal spasticity who were scheduled for BoNT injections following a stroke.Assessments were undertaken before BoNT injections and at the first and third months after treatment.Clinical evaluations included the Modified Ashworth Scale (MAS) for spasticity, the Visual Analog Scale (VAS) for pain and spasticity severity, Brunnstrom staging for hand, upper, and lower extremities, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) for anxiety and depression levels, and the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) for quality of life.Results: Post-treatment assessments revealed a statistically significant reduction in Brunnstrom staging (hand, upper, and lower extremities) at both the first and third months compared to pre-treatment (p<0.001).Similarly, MAS, VAS, HADS-A, HADS-D, PSQI, and EQ-5D-5L scores showed significant improvements at the first and third months after treatment (p<0.001).Discussion: The results of this study demonstrated that BoNT, frequently used in the treatment of stroke-related spasticity, had a positive effect on sleep quality in stroke patients.