CLINICO-ANATOMICAL CORRELATION OF ALTERED SLEEP RHYTHM IN STROKE VICTIMS

H. Poornima*

ABSTRACT

Background: We have observed a change in sleep pattern of stroke patients which is extremely difficult for the caretaker. Management is difficult because continuous sleep during night with drugs interferes with rehabilitation. Purpose of the study is to find out whether there is any pattern of sleep change in right or left hemiplegia and whether it can be correlated with site of infarct. Brainstem strokes are excluded because they can directly involve the wakefulness pathway. Method: 60 patients admitted with hemiplegia in the department of medicine were selected of whom 30 cases were of right hemiplegia and 30 cases were of left hemiplegia. 30 cases of hospital admissions for minor ailment like viral feverwere taken as controls. CT scan of the brain was taken to find out the arterial territory. Sleep disturbance was verified according to the General Curriculum of sleep. Results: 80%of patients with left hemiplegia and 13.33% with right hemiplegia had sleep abnormalities. The commonest sleep abnormality was early morning awakening in 76.9% case of left hemiplegia. Other abnormalities were broken-up sleep, reversal of sleep rhythm, late sleep onset, excessive daytime sleep and decreased sleep. Right hemiplegia patients showed very little sleep abnormalities, except reversal of sleep rhythm in one patient and broken up sleep in the other. Conclusion: Sleep rhythm abnormality is likely to be a part of the structural abnormality in stroke.

Keywords: Sleep rhythm, Stroke, Clinico-anatomical correlation.