The impact of short and long sleep duration on instrumental activities of daily living among stroke survivors

OBJECTIVE: Stroke survivors generally have problems completing instrumental activities of daily living (IADL; eg, preparing meals, chores, taking a bath, and managing finances). However, it is unclear how stroke survivors might stave off IADL issues. Studies indicating that sleep has restorative neurological effects provide potential mechanisms to address issues with IADL. The aim of this study was to ascertain the association between sleep duration (short or long sleep duration) and IADL among stroke survivors and those without a stroke history. METHODS: Data of 486,619 participants were analyzed from the 2000 to 2015 National Health Interview Survey (NHIS), a nationally representative sample. Measures of self-reported stroke, sociodemographic variables, sleep duration, and IADL problems were collected. Binary logistic regression was utilized to analyze the relationship of short (≤6 hours) and long (≥9 hours) sleep duration with limitations to IADL. RESULTS: Of the sample, 3% reported a physician-diagnosed stroke event. The mean age was 45.73 years; 52.7% were female; 77.4% were White; 14.2% were Black; 41.3% were married, 62.7% were employed; 31.1% reported that annual family income was less than $35,000; 87% reported good-to-excellent health; and 29.7% reported short sleep (≤6 hours). Approximately 30% of stroke survivors reported IADL problems, and 34.4% who reported IADL problems were short sleepers. Among stroke survivors, long sleepers were 97% more likely than average sleepers to report IADL problems (OR =1.97, 95% CI =1.71–2.26, P<0.001) adjusting for age, sex, race, marital status, poverty, and health. CONCLUSION: Findings from our study indicate that, among stroke survivors, long sleepers were more likely to report IADL problems compared to average sleepers (7–8 hours). Future studies should investigate other potential mediators such as severity of stroke, medication, comorbidities, level of impairment, and whether improving sleep among stroke survivors may improve IADL.