Investigating Sleep Quality in Post-Stroke Delirium: A Scoping Review

Background: Delirium affects approximately 59% of hospitalized patients with intracerebral hemorrhage and is associated with poor outcomes. Sleep-wake cycle disturbances are hypothesized to contribute to delirium development, particularly in neurointensive care settings where frequent sleep interruptions occur. Methods: We conducted a scoping review of literature published between 2014-2024 using PubMed, CINAHL, Embase, and Cochrane databases. Studies were included if they observed sleep in adult stroke populations. Results: Four observational studies (2018-2023) met inclusion criteria, with sample sizes ranging from 20-112 participants. All studies included patients with ICH. All studies reported associations between poor sleep in patients with ICH and delirium prevalence, but with inconsistent findings. Sleep measurement methods varied among all studies and lacked direct quantification of sleep. Conclusion: Few studies have evaluated sleep-delirium relationships after acute stroke. Measurement inconsistencies and small sample sizes limit conclusions. Future research should standardize methodologies of delirium assessment, quantify sleep architecture in post-stroke delirium to understand this relationship, and evaluate interventions aimed at improving sleep quality to potentially reduce delirium incidence.