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Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis
BACKGROUND: Research on sleep after stroke has focused mainly on sleep disordered breathing. However, the extend to which sleep physiology is altered in stroke survivors, how these alterations compare to healthy volunteers, and how sleep changes might affect recovery as well as physical and mental h...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780740/ https://www.ncbi.nlm.nih.gov/pubmed/26949966 http://dx.doi.org/10.1371/journal.pone.0148496 |
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author | Baglioni, Chiara Nissen, Christoph Schweinoch, Adrian Riemann, Dieter Spiegelhalder, Kai Berger, Mathias Weiller, Cornelius Sterr, Annette |
author_facet | Baglioni, Chiara Nissen, Christoph Schweinoch, Adrian Riemann, Dieter Spiegelhalder, Kai Berger, Mathias Weiller, Cornelius Sterr, Annette |
author_sort | Baglioni, Chiara |
collection | PubMed |
description | BACKGROUND: Research on sleep after stroke has focused mainly on sleep disordered breathing. However, the extend to which sleep physiology is altered in stroke survivors, how these alterations compare to healthy volunteers, and how sleep changes might affect recovery as well as physical and mental health has yet to be fully researched. Motivated by the view that a deeper understanding of sleep in stroke is needed to account for its role in health and well-being as well as its relevance for recovery and rehabilitation, we conducted a systematic review and meta-analysis of polysomnographic studies comparing stroke to control populations. METHOD: Medline and PsycInfo databases were searched using "stroke" and words capturing polysomnographic parameters as search terms. This yielded 1692 abstracts for screening, with 15 meeting the criteria for systematic review and 9 for meta-analysis. Prisma best practice guidelines were followed for the systematic review; the Comprehensive Meta-Analysis software was used for random effects modelling. RESULTS: The meta-analysis revealed that patients with stroke have poorer sleep than controls. Patients had lower sleep efficiency (mean 75% vs 84%), shorter total-sleep-time (309.4 vs 340.3 min) and more wake-after-sleep-onset (97.2 vs 53.8 min). Patients also spend more time in stage 1 (13% vs 10%) and less time in stage 2 sleep (36% vs 45%) and slow-wave-sleep (10% vs 12%). No group differences were identified for REM sleep. The systematic review revealed a strong bias towards studies in the early recovery phase of stroke, with no study reporting specifically on patients in the chronic state. Moreover, participants in the control groups included community samples as well as other patients groups. CONCLUSIONS: These results indicate poorer sleep in patients with stroke than controls. While strongly suggestive in nature, the evidence base is limited and methodologically diverse, and hands a clear mandate for further research. A particular need regards polysomnographic studies in chronic community-dwelling patients compared to age-matched individuals. |
format | Online Article Text |
id | pubmed-4780740 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-47807402016-03-23 Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis Baglioni, Chiara Nissen, Christoph Schweinoch, Adrian Riemann, Dieter Spiegelhalder, Kai Berger, Mathias Weiller, Cornelius Sterr, Annette PLoS One Research Article BACKGROUND: Research on sleep after stroke has focused mainly on sleep disordered breathing. However, the extend to which sleep physiology is altered in stroke survivors, how these alterations compare to healthy volunteers, and how sleep changes might affect recovery as well as physical and mental health has yet to be fully researched. Motivated by the view that a deeper understanding of sleep in stroke is needed to account for its role in health and well-being as well as its relevance for recovery and rehabilitation, we conducted a systematic review and meta-analysis of polysomnographic studies comparing stroke to control populations. METHOD: Medline and PsycInfo databases were searched using "stroke" and words capturing polysomnographic parameters as search terms. This yielded 1692 abstracts for screening, with 15 meeting the criteria for systematic review and 9 for meta-analysis. Prisma best practice guidelines were followed for the systematic review; the Comprehensive Meta-Analysis software was used for random effects modelling. RESULTS: The meta-analysis revealed that patients with stroke have poorer sleep than controls. Patients had lower sleep efficiency (mean 75% vs 84%), shorter total-sleep-time (309.4 vs 340.3 min) and more wake-after-sleep-onset (97.2 vs 53.8 min). Patients also spend more time in stage 1 (13% vs 10%) and less time in stage 2 sleep (36% vs 45%) and slow-wave-sleep (10% vs 12%). No group differences were identified for REM sleep. The systematic review revealed a strong bias towards studies in the early recovery phase of stroke, with no study reporting specifically on patients in the chronic state. Moreover, participants in the control groups included community samples as well as other patients groups. CONCLUSIONS: These results indicate poorer sleep in patients with stroke than controls. While strongly suggestive in nature, the evidence base is limited and methodologically diverse, and hands a clear mandate for further research. A particular need regards polysomnographic studies in chronic community-dwelling patients compared to age-matched individuals. Public Library of Science 2016-03-07 /pmc/articles/PMC4780740/ /pubmed/26949966 http://dx.doi.org/10.1371/journal.pone.0148496 Text en © 2016 Baglioni et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Baglioni, Chiara Nissen, Christoph Schweinoch, Adrian Riemann, Dieter Spiegelhalder, Kai Berger, Mathias Weiller, Cornelius Sterr, Annette Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis |
title | Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis |
title_full | Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis |
title_fullStr | Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis |
title_short | Polysomnographic Characteristics of Sleep in Stroke: A Systematic Review and Meta-Analysis |
title_sort | polysomnographic characteristics of sleep in stroke: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780740/ https://www.ncbi.nlm.nih.gov/pubmed/26949966 http://dx.doi.org/10.1371/journal.pone.0148496 |
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