Sleep Disorders in Stroke Patients: A Literature Review

Abstract

Stroke was a major cause of death and long-term disability and was frequently accompanied by sleep disorders that affected rehabilitation and quality of life. Post-stroke sleep disturbances could precede stroke as a risk factor or emerge afterward as a consequence of central nervous system damage and various accompanying factors. This literature review was conducted to discuss the definition, epidemiology, etiology, physiology, pathophysiology, classification, clinical manifestations, diagnosis, management, and prognosis of sleep disorders in stroke based on a search of the scientific literature through Google Scholar and PubMed. The spectrum of sleep disorders in stroke patients included sleep-disordered breathing, insomnia, excessive daytime sleepiness, hypersomnia, restless legs syndrome, periodic limb movement disorder, circadian rhythm disorders, and parasomnia, associated with damage to brain structures regulating sleep, respiratory disturbances, psychological factors, medical comorbidities, and environmental factors during care. Diagnosis was established through history taking, screening instruments such as the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale, and supporting examinations such as polysomnography and actigraphy. Management included non-pharmacological approaches such as cognitive behavioral therapy for insomnia and continuous positive airway pressure, as well as pharmacological therapy in certain conditions. Sleep disorders were associated with slower neurological recovery, reduced quality of life, cognitive impairment, and an increased risk of recurrent stroke. This review concluded that sleep disorders were common but frequently underdiagnosed non-motor complications of stroke, highlighting the importance of early identification and appropriate management as part of comprehensive stroke care to optimize recovery and long-term prognosis.