Frequency and evolution of sleep-wake disturbances after ischemic stroke: A 2-year prospective study of 437 patients.

Duss, Simone B; Bauer-Gambelli, Stefan A; Bernasconi, Corrado; Dekkers, Martijn P J; Gorban-Peric, Corina; Kuen, Doris; Seiler, Andrea; Oberholzer, Michael; Alexiev, Filip; Lippert, Julian; Brill, Anne-Kathrin; Ott, Sebastian R; Zubler, Frédéric; Horvath, Thomas; Schmidt, Markus H; Manconi, Mauro; Bassetti, Claudio L A (2023). Frequency and evolution of sleep-wake disturbances after ischemic stroke: A 2-year prospective study of 437 patients. Sleep medicine, 101, pp. 244-251. Elsevier 10.1016/j.sleep.2022.10.007

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In the absence of systematic and longitudinal data, this study prospectively assessed both frequency and evolution of sleep-wake disturbances (SWD) after stroke.


In 437 consecutively recruited patients with ischemic stroke or transient ischemic attack (TIA), stroke characteristics and outcome were assessed within the 1st week and 3.2 ± 0.3 years (M±SD) after the acute event. SWD were assessed by interview and questionnaires at 1 and 3 months as well as 1 and 2 years after the acute event. Sleep disordered breathing (SDB) was assessed by respirography in the acute phase and repeated in one fifth of the participants 3 months and 1 year later.


Patients (63.8% male, 87% ischemic stroke and mean age 65.1 ± 13.0 years) presented with mean NIHSS-score of 3.5 ± 4.5 at admission. In the acute phase, respiratory event index was >15/h in 34% and >30/h in 15% of patients. Over the entire observation period, the frequencies of excessive daytime sleepiness (EDS), fatigue and insomnia varied between 10-14%, 22-28% and 20-28%, respectively. Mean insomnia and EDS scores decreased from acute to chronic stroke, whereas restless legs syndrome (RLS) percentages (6-9%) and mean fatigue scores remained similar. Mean self-reported sleep duration was enhanced at acute stroke (month 1: 07:54 ± 01:27h) and decreased at chronic stage (year 2: 07:43 ± 01:20h).


This study documents a high frequency of SDB, insomnia, fatigue and a prolonged sleep duration after stroke/TIA, which can persist for years. Considering the negative effects of SWD on physical, brain and mental health these data suggest the need for a systematic assessment and management of post-stroke SWD.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Duss, Simone, Bauer, Stefan (B), Bernasconi, Corrado Angelo, Dekkers, Martijn, Gorban Peric, Corina, Kuen, Doris, Seiler, Andrea Barbara, Oberholzer, Michael, Alexiev, Filip, Lippert, Julian Peter, Brill, Anne-Kathrin, Ott, Sebastian Robert, Zubler, Frédéric, Horvath, Thomas Nikolaus, Schmidt, Markus Helmut, Manconi, Mauro, Bassetti, Claudio L.A.


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

30 Nov 2022 10:26

Last Modified:

29 Mar 2023 23:38

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Epidemiology Excessive daytime sleepiness Fatigue Insomnia Outcome Restless legs syndrome Sleep Sleep disordered breathing Sleep duration Stroke




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