The Relationship Between Sleep Quality and Clinical and Demographic Factors After Stroke

Objective: Post-stroke sleep disturbances are significant complications that impact the rehabilitation process. This study aimed to evaluate sleep quality in post-stroke patients and examine its relationship with clinical and demographic factors, including functional and psychological status. Method: This cross-sectional study included 92 post-stroke patients in inpatient rehabilitation. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI), with patients categorized into good (≤5) and poor (>5) sleep groups. Depression and anxiety symptoms were measured with the hospital anxiety and depression scale (HADS). Functional status and motor recovery were evaluated using the modified Barthel index (MBI) and the Brunnstrom motor assessment, respectively. Results: Fifty percent of participants had poor sleep quality. No significant differences were observed between groups in age, gender, stroke type, or body mass index (p>0.05). Compared with the good sleep quality group, the poor sleep quality group had significantly shorter time since stroke (p=0.013), lower Brunnstrom motor stage scores (p<0.001), greater dependency as indicated by MBI scores (p<0.001), and higher HADS depression scores (p<0.001) and anxiety scores (p=0.002). In addition, PSQI scores were significantly negatively correlated with stroke duration, Brunnstrom stages, and MBI scores, and were positively correlated with HADS scores. Conclusion: Half of the stroke patients in this study had poor sleep quality, which was significantly associated with impaired motor recovery, reduced independence in daily activities, and increased anxiety and depression. These findings emphasize the importance of regular sleep assessments and multidisciplinary sleep management within post-stroke rehabilitation programs.