Sleep quality, not sleep apnoea, is associated with post-stroke fatigue in acute ischemic stroke: a cross-sectional Norwegian study (NORFAST).

Abstract

Post-stroke fatigue affects rehabilitation, daily activities, and quality of life. Its relationship with sleep remains unclear. We aimed in the acute stroke phase to (a) describe fatigue and sleep using self-reported and objective sleep measures, (b) describe sleep apnoea and (c) explore the associations between sleep measures and post-stroke fatigue. This cross-sectional study examined Norwegian adults within 14 days of first ischaemic stroke. Fatigue was assessed with the Fatigue Severity Scale. Self-reported sleep factors (Pittsburgh Sleep Quality Index [PSQI], Epworth Sleepiness Scale) and objective WatchPAT measures (apnoea-hypopnea, sleep time, efficiency, REM/deep sleep) served as exposure variables. Multivariable regression models, adjusted for age, sex, mRS, and depression or anxiety symptoms, were used to examine associations between sleep and fatigue. Participants (<i>n</i> = 107, mean age 65 (SD14) years, <i>n</i> = 65(61%) male) had a mean NIHSS score of 2.5 [SD3.3], Fatigue Severity Scale score of 3.11 [SD1.82], and <i>n</i> = 71 (66%) scored as having disturbed sleep (PSQI). Mean total sleep time (<i>n</i> = 81) was 7.04 [SD1.46] hours and 54 (71%) had sleep apnoea. In the final multivariable model, only poor sleep quality (<i>b</i> = 0.45, <i>p</i> = 0.010) was associated with post-stroke fatigue. Addressing sleep quality in the acute stroke phase may benefit post-stroke fatigue.