Download PDF
CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(03): e335-e343
DOI: 10.1055/s-0043-1772805
Review Article

The Importance of Sleep for Successful Neurorehabilitation after Stroke

Cristina Frange 
1   Department of Neurology and Neurosurgery, Universidade Federal De São Paulo, São Paulo, São Paulo, Brazil
,
Brian James Murray
2   Department of Medicine, Division of Neurology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
,
Fernando Morgadinho Santos Coelho
1   Department of Neurology and Neurosurgery, Universidade Federal De São Paulo, São Paulo, São Paulo, Brazil
3   Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Sleep has important clinical implications for neurorehabilitation after stroke. We aimed to systematically explore sleep (including naps) as an essential factor in the neurorehabilitation of patients after stroke. After titles and abstracts were screened, 49 full texts were reviewed, and 7 were included in this review. Data were extracted and assessed for quality and risk of bias. We looked at any neurorehabilitation setting, and compared sleep with no sleep and explored these factors in stroke patients versus healthy individuals. Rehabilitation is critical for many activities that may need to be learned or re-learned following stroke and for returning to everyday life. In this context, sleep is essential in neurorehabilitation and physical therapy practice as it supports neuroplasticity, memory, and learning. The available data suggest that sleep should be considered in the treatment plan for successfully targeted physiotherapy to optimize cognitive and motor learning. Physical therapists should advise about sleep hygiene and therapies to improve sleep, both quality and quantity.

Keywords

sleep - sleep disorders - stroke - rehabilitation - neurorehabilitation - physical therapy - neuroplasticity


Publication History

Received: 23 May 2022

Accepted: 24 October 2022

Article published online:
11 September 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Fultz NE, Bonmassar G, Setsompop K. et al. Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep. Science 2019; 366 (6465) 628-631
    CrossrefPubMedSearch in Google Scholar
  • 2 Tononi G, Cirelli C. Sleep and synaptic homeostasis: a hypothesis. Brain Res Bull 2003; 62 (02) 143-150
    CrossrefPubMedSearch in Google Scholar
  • 3 Bassetti CLA. Sleep and stroke: A bidirectional relationship with clinical implications. Sleep Med Rev 2019; 45: 127-128
    CrossrefPubMedSearch in Google Scholar
  • 4 Duss SB, Seiler A, Schmidt MH. et al. The role of sleep in recovery following ischemic stroke: A review of human and animal data. Neurobiol Sleep Circadian Rhythms 2016; 2: 94-105
    CrossrefPubMedSearch in Google Scholar
  • 5 Boulos MI, Jairam T, Kendzerska T, Im J, Mekhael A, Murray BJ. Normal polysomnography parameters in healthy adults: a systematic review and meta-analysis. Lancet Respir Med 2019; 7 (06) 533-543
    CrossrefPubMedSearch in Google Scholar
  • 6 Pasic Z, Smajlovic D, Dostovic Z, Kojic B, Selmanovic S. Incidence and types of sleep disorders in patients with stroke. Med Arh 2011; 65 (04) 225-227
    CrossrefPubMedSearch in Google Scholar
  • 7 Oliveira GDP, Vago ERL, Prado GFD, Coelho FMS. The critical influence of nocturnal breathing complaints on the quality of sleep after stroke: the Pittsburgh Sleep Quality Index and STOP-BANG. Arq Neuropsiquiatr 2017; 75 (11) 785-788
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Müller C, Achermann P, Bischof M, Nirkko AC, Roth C, Bassetti CL. Visual and spectral analysis of sleep EEG in acute hemispheric stroke. Eur Neurol 2002; 48 (03) 164-171
    CrossrefPubMedSearch in Google Scholar
  • 9 Bassetti CL, Aldrich MS. Sleep electroencephalogram changes in acute hemispheric stroke. Sleep Med 2001; 2 (03) 185-194
    CrossrefPubMedSearch in Google Scholar
  • 10 Gottselig JM, Bassetti CL, Achermann P. Power and coherence of sleep spindle frequency activity following hemispheric stroke. Brain 2002; 125 (Pt 2): 373-383
    CrossrefPubMedSearch in Google Scholar
  • 11 Giubilei F, Iannilli M, Vitale A. et al. Sleep patterns in acute ischemic stroke. Acta Neurol Scand 1992; 86 (06) 567-571
    CrossrefPubMedSearch in Google Scholar
  • 12 De Gennaro L, Ferrara M. Sleep spindles: an overview. Sleep Med Rev 2003; 7 (05) 423-440
    CrossrefPubMedSearch in Google Scholar
  • 13 Al-Dughmi M, Al-Sharman A, Stevens S, Siengsukon CF. Sleep characteristics of individuals with chronic stroke: a pilot study. Nat Sci Sleep 2015; 7: 139-145
    PubMedSearch in Google Scholar
  • 14 Johnson KG, Johnson DC. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J Clin Sleep Med 2010; 6 (02) 131-137
    CrossrefPubMedSearch in Google Scholar
  • 15 Sahlin C, Sandberg O, Gustafson Y. et al. Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Arch Intern Med 2008; 168 (03) 297-301
    CrossrefPubMedSearch in Google Scholar
  • 16 Redline S, Yenokyan G, Gottlieb DJ. et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 2010; 182 (02) 269-277
    CrossrefPubMedSearch in Google Scholar
  • 17 Jonas DE, Amick HR, Feltner C. et al. Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2017; 317 (04) 415-433
    CrossrefPubMedSearch in Google Scholar
  • 18 Krakauer JW, Carmichael ST, Corbett D, Wittenberg GF. Getting neurorehabilitation right: what can be learned from animal models?. Neurorehabil Neural Repair 2012; 26 (08) 923-931
    CrossrefPubMedSearch in Google Scholar
  • 19 Alhwoaimel N, Turk R, Warner M. et al. Do trunk exercises improve trunk and upper extremity performance, post stroke? A systematic review and meta-analysis. NeuroRehabilitation 2018; 43 (04) 395-412
    CrossrefPubMedSearch in Google Scholar
  • 20 Schröder J, Truijen S, Van Criekinge T, Saeys W. Feasibility and effectiveness of repetitive gait training early after stroke: A systematic review and meta-analysis. J Rehabil Med 2019; 51 (02) 78-88
    CrossrefPubMedSearch in Google Scholar
  • 21 Winstein CJ, Stein J, Arena R. et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2016; 47 (06) e98-e169
    CrossrefPubMedSearch in Google Scholar
  • 22 de Sousa DG, Harvey LA, Dorsch S, Glinsky JV. Interventions involving repetitive practice improve strength after stroke: a systematic review. J Physiother 2018; 64 (04) 210-221
    CrossrefPubMedSearch in Google Scholar
  • 23 Dobkin BH, Dorsch A. New evidence for therapies in stroke rehabilitation. Curr Atheroscler Rep 2013; 15 (06) 331
    Search in Google Scholar
  • 24 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 (07) e1000097
    CrossrefPubMedSearch in Google Scholar
  • 25 Phillips B, Ball C, Sacket D. Oxford Centre for Evidence-based Medicine – Levels of Evidence. 2009
    Search in Google Scholar
  • 26 Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 2003; 73 (09) 712-716
    CrossrefPubMedSearch in Google Scholar
  • 27 Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52 (06) 377-384
    CrossrefPubMedSearch in Google Scholar
  • 28 Backhaus W, Braass H, Gerloff C, Hummel FC. Can Daytime Napping Assist the Process of Skills Acquisition After Stroke?. Front Neurol 2018; 9: 1002
    CrossrefPubMedSearch in Google Scholar
  • 29 Siengsukon C, Boyd LA. Sleep enhances off-line spatial and temporal motor learning after stroke. Neurorehabil Neural Repair 2009; 23 (04) 327-335
    CrossrefPubMedSearch in Google Scholar
  • 30 Siengsukon CF, Boyd LA. Sleep to learn after stroke: implicit and explicit off-line motor learning. Neurosci Lett 2009; 451 (01) 1-5
    CrossrefPubMedSearch in Google Scholar
  • 31 Siengsukon CF, Boyd LA. Sleep enhances implicit motor skill learning in individuals poststroke. Top Stroke Rehabil 2008; 15 (01) 1-12
    CrossrefPubMedSearch in Google Scholar
  • 32 Al-Dughmi M, Al-Sharman A, Stevens S, Siengsukon CF. Executive Function Is Associated With Off-Line Motor Learning in People With Chronic Stroke. J Neurol Phys Ther 2017; 41 (02) 101-106
    CrossrefPubMedSearch in Google Scholar
  • 33 Lubart AA, Leibovitz AI, Peleg LD. et al. Action Observation of Motor Skills Followed by Immediate Sleep Enhances the Motor Rehabilitation of Older Adults With Stroke. J Geriatr Phys Ther 2017; 00: 1-4
    Search in Google Scholar
  • 34 Siengsukon C, Al-Dughmi M, Al-Sharman A, Stevens S. Sleep Parameters, Functional Status, and Time Post-Stroke are Associated with Offline Motor Skill Learning in People with Chronic Stroke. Front Neurol 2015; 6: 225
    CrossrefPubMedSearch in Google Scholar
  • 35 Mander BA, Winer JR, Walker MP. Sleep and Human Aging. Neuron 2017; 94 (01) 19-36
    CrossrefPubMedSearch in Google Scholar
  • 36 Hahn M, Joechner AK, Roell J. et al. Developmental changes of sleep spindles and their impact on sleep-dependent memory consolidation and general cognitive abilities: A longitudinal approach. Dev Sci 2019; 22 (01) e12706
    CrossrefPubMedSearch in Google Scholar
  • 37 Scullin MK, Gao C, Fillmore P, Roberts RL, Pruett N, Bliwise DL. Rapid eye movement sleep mediates age-related decline in prospective memory consolidation. Sleep 2019; 42 (06) zsz055
    CrossrefPubMedSearch in Google Scholar
  • 38 Carskadon MA, Dement WC, Mitler MM, Roth T, Westbrook PR, Keenan S. Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. Sleep 1986; 9 (04) 519-524
    CrossrefPubMedSearch in Google Scholar
  • 39 Paolucci S, Antonucci G, Grasso MG. et al. Functional outcome of ischemic and hemorrhagic stroke patients after inpatient rehabilitation: a matched comparison. Stroke 2003; 34 (12) 2861-2865
    CrossrefPubMedSearch in Google Scholar
  • 40 Katan M, Luft A. Global Burden of Stroke. Semin Neurol 2018; 38 (02) 208-211
    Thieme ConnectPubMedSearch in Google Scholar
  • 41 Weiller C, Ramsay SC, Wise RJ, Friston KJ, Frackowiak RS. Individual patterns of functional reorganization in the human cerebral cortex after capsular infarction. Ann Neurol 1993; 33 (02) 181-189
    CrossrefPubMedSearch in Google Scholar
  • 42 Maier MA, Armand J, Kirkwood PA, Yang HW, Davis JN, Lemon RN. Differences in the corticospinal projection from primary motor cortex and supplementary motor area to macaque upper limb motoneurons: an anatomical and electrophysiological study. Cereb Cortex 2002; 12 (03) 281-296
    CrossrefPubMedSearch in Google Scholar
  • 43 Plautz EJ, Milliken GW, Nudo RJ. Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiol Learn Mem 2000; 74 (01) 27-55
    CrossrefPubMedSearch in Google Scholar
  • 44 Walker MP, Stickgold R, Alsop D, Gaab N, Schlaug G. Sleep-dependent motor memory plasticity in the human brain. Neuroscience 2005; 133 (04) 911-917
    CrossrefPubMedSearch in Google Scholar
  • 45 Walker MP, Brakefield T, Morgan A, Hobson JA, Stickgold R. Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron 2002; 35 (01) 205-211
    CrossrefPubMedSearch in Google Scholar
  • 46 Krakauer JW. Arm function after stroke: from physiology to recovery. Semin Neurol 2005; 25 (04) 384-395
    Thieme ConnectPubMedSearch in Google Scholar
  • 47 Zunzunegui C, Gao B, Cam E, Hodor A, Bassetti CL. Sleep disturbance impairs stroke recovery in the rat. Sleep 2011; 34 (09) 1261-1269
    CrossrefPubMedSearch in Google Scholar
  • 48 Urakami Y. Relationships between sleep spindles and activities of the cerebral cortex after hemispheric stroke as determined by simultaneous EEG and MEG recordings. J Clin Neurophysiol 2009; 26 (04) 248-256
    CrossrefPubMedSearch in Google Scholar
  • 49 Terzoudi A, Vorvolakos T, Heliopoulos I, Livaditis M, Vadikolias K, Piperidou H. Sleep architecture in stroke and relation to outcome. Eur Neurol 2009; 61 (01) 16-22
    CrossrefPubMedSearch in Google Scholar
  • 50 Martynas Z, Ramune L, Raminta M, Osvaldas R. Arousals and macrostructure of sleep: importance of NREM stage 2 reconsidered. Sleep Sci 2013; 6 (03) 6
    Search in Google Scholar
  • 51 Huber R, Ghilardi MF, Massimini M, Tononi G. Local sleep and learning. Nature 2004; 430 (6995) 78-81
    CrossrefPubMedSearch in Google Scholar
  • 52 Poryazova R, Huber R, Khatami R. et al. Topographic sleep EEG changes in the acute and chronic stage of hemispheric stroke. J Sleep Res 2015; 24 (01) 54-65
    CrossrefPubMedSearch in Google Scholar
  • 53 Huber R, Ghilardi MF, Massimini M. et al. Arm immobilization causes cortical plastic changes and locally decreases sleep slow wave activity. Nat Neurosci 2006; 9 (09) 1169-1176
    CrossrefPubMedSearch in Google Scholar
  • 54 Maquet P. The role of sleep in learning and memory. Science 2001; 294 (5544) 1048-1052
    CrossrefPubMedSearch in Google Scholar
  • 55 Hoffman KL, McNaughton BL. Sleep on it: cortical reorganization after-the-fact. Trends Neurosci 2002; 25 (01) 1-2
    CrossrefPubMedSearch in Google Scholar
  • 56 Stickgold R, Hobson JA, Fosse R, Fosse M. Sleep, learning, and dreams: off-line memory reprocessing. Science 2001; 294 (5544) 1052-1057
    CrossrefPubMedSearch in Google Scholar
  • 57 Benington JH, Frank MG. Cellular and molecular connections between sleep and synaptic plasticity. Prog Neurobiol 2003; 69 (02) 71-101
    CrossrefPubMedSearch in Google Scholar