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Titre : | Objective Sleep Measures in Inpatients With Subacute Stroke Associated With Levels and Improvements in Activities of Daily Living (2018) |
Auteurs : | Ren-Jing Huang ; Ching-Hsiang Lai ; Shin-Da Lee |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 99, n° 4, 2018) |
Article en page(s) : | p. 699-706 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Hypertension intracrânienne ; Pronostic ; Syndromes d'apnées du sommeil ; Troubles de l'endormissement et du maintien du sommeil |
Mots-clés: | Cerebrovascular Disorders ; Angiopathies intracrâniennes ; Intracranial Hypertension ; Sleep Initiation and Maintenance Disorders ; Prognosis ; Sleep Apnea Syndromes |
Résumé : |
Objective To investigate whether objective polysomnographic measures of prevalent sleep problems such as sleep-disordered-breathing (SDB) and insomnia are associated with activities of daily living levels in inpatients at rehabilitation units. Design Retrospective and observational study. Setting Single rehabilitation center. Participants Inpatients with subacute stroke (N=123) (61.6+13.1 years; 23.8+3.4 kg/m2; 33% women; 90.5+36.7 days post-stroke) underwent a 1-night polysomnographic study and a 1-month inpatient rehabilitation program. Main outcome measures Admission and discharge Barthel Index (BI) scores and its change scores. Results One hundred three (92%) patients had moderate-to-severe SDB (46.7+25.1 events/h in the apnea-hypopnea index), and 24 (19.5%) patients had acceptable continuous positive airway pressure adherence. Diverse values were found for total sleep time (259+71 min), sleep efficiency (69.5%+19.3%), sleep latency (24.3+30.9 min), and wakefulness after sleep onset (93.1+74.2 min). Admission BI scores and the BI change scores were 33.8+23.2 and 10.1+9.2, respectively. The National Institutes of Health Stroke Scale (NIHSS, 10.2+5.6), available in 57 (46%) patients, was negatively associated with admission levels and gains in BI change scores (P<.001 respectively in a univariate analysis. regression models with backward selection excluding nihss score both age and wakefulness after sleep onset were negatively associated r2="0.260)" admission bi scores. comorbidity of hypertension latency percentage stage non eye movement desaturation events adjusted gains.> Conclusions Based on objective sleep measures, insomnia rather than SDB in inpatients with subacute stroke was associated negatively with admission levels of activity of daily living and its improvement after a 1-month rehabilitation course. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |