Effects of Hypnotics on Sleep Patterns and Functional Recovery of Patients with Subacute Stroke

Kim CR, Chun MH, Han EY: Effects of hypnotics on sleep patterns and functional recovery of patients with subacute stroke. Am J Phys Med Rehabil 2010;89:315-322. Objective: To identify relationships between sleep patterns and functional outcomes in patients with subacute stroke with insomnia. Design: We prospectively studied 30 patients with subacute stroke. Each patient completed the St. Mary's Hospital sleep questionnaire, the Korean modified Barthel index, a computerized neuropsychological test, and the Beck depression inventory. The time interval between baseline and follow-up was 3 wks. Patients with insomnia were all treated with hypnotics, and patients were divided into two groups according to sleep patterns. Results: Poor sleep quality, decreased total sleep time, and increased frequency of nocturnal awakening were observed in patients with insomnia, but sleep patterns improved, when hypnotics were administered, to levels comparable with those of the (noninsomnia) control group. There was no significant difference in functional, cognitive, or depressive status between the insomnia and noninsomnia groups at baseline, but attention in patients with insomnia tended to be lower. At follow-up, functional and cognitive status had improved in both groups, and there was no significant difference between the two groups in sleep quality, sleep time, or nocturnal awakening. Conclusions: Patients with stroke with insomnia showed poor sleep patterns. Active management improved sleep patterns and helped such patients achieve functional and cognitive outcomes equivalent to those attained by patients without insomnia.