0871 Sleep Disturbance and Disability Severity After Stroke Hospitalization

Abstract Introduction Stroke survivors frequently report sleep disturbance and feelings of not being back to where they were, physically, prior to their event. Post-stroke sleep disturbance may be a factor related to sub-optimal recovery. Methods Data came from the Reactions to Acute Care and Hospitalizations (ReACH) Stroke-Sleep Study, an observational cohort assessing the relationship of sleep with secondary cardiovascular risk in the year following stroke or transient ischemic attack (TIA). Data were collected using self-reported questionnaires at 1 month and chart reviews. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), with a score 5 indicating poor sleep quality. Insomnia symptoms were assessed with a single item from the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): “In the past month, how much were you bothered by trouble falling or staying asleep?” with a rating of “moderately,” “quite a bit,” or “extremely” indicating presence of insomnia symptoms. Degree of disability was assessed using the Simplified Modified Rankin Scale Questionnaire (smRSq), with presence of disability defined as smRSq score 2. Binary logistic regression was used to analyze the relationships between presence of poor sleep and insomnia, separately, with presence of disability at 1-month post-hospitalization. Analyses were adjusted for age, gender, race/ethnicity, and stroke severity (NIH Stroke Scale). Results The sample included n=436 participants (mean SD age=60.2 15.5 y, 52% Hispanic/Latino, 59% female). Fifty-six percent of participants reported poor sleep quality, 27% reported presence of insomnia symptoms, and 23% reported presence of disability at 1 month. Poor global sleep quality (vs. good sleep) was significantly associated with presence of disability (adjusted OR: 2.45, 95% CI: 1.48-4.04, p 0.001). Insomnia (vs. no or mild symptoms) was also significantly associated with presence of disability (adjusted OR: 2.40, 95% CI: 1.50-3.85, p 0.001). Conclusion More than half of participants reported poor sleep quality, and over a quarter reported insomnia symptoms, 1 month after stroke hospitalization. Compared to those without sleep problems, individuals with sleep disturbance had nearly 2.5 times higher odds of disability. While causal relationships cannot be concluded based on this cross-sectional analysis, findings suggest that sleep may play a role in stroke survivors’ outcomes and recovery. Support (if any) R01HL141494