REM sleep as predictor of functional outcome after stroke: A translational study.
Sleep. 2018 Jul 19;:
Authors: Pace M, Camilo MR, Seiler A, Duss SB, Mathis J, Manconi M, Bassetti CL
Study Objectives: Sleep disturbances are common in acute stroke patients and are linked with a negative stroke outcome. However, it is also unclear which and how such changes may be related to stroke outcome. To explore this link, we performed a sleep-EEG study in animals and humans after ischemic stroke.
Methods: (1) Animal-study: 12 male rats were assigned to two groups: ischemia (IS) and sham-surgery (Sham). In both groups, sleep architecture was investigated 24h before surgery and for the following 3 days. (2) Human-study: 153 patients with ischemic stroke participating in the the SAS-CARE prospective, multicentre-cohort study had a polysomnography within 9 days after stroke onset. Functional stroke outcome was assessed by the modified Rankin Scale (mRS) at hospital discharge (short-term-outcome) and at a 3 months follow-up (long-term-outcome).
Results: (1) Animal-study: Rapid eye movement (REM) sleep was significantly reduced in the IS group compared to the Sham group. (2) Human-study: Patients with poor short-term functional outcome had a reduction of REM sleep and prolonged REM latency during the acute phase of stroke. REM latency was the only sleep-EEG variable found to be significantly related to short and long-term functional impairment in a multiple linear regression analysis.
Conclusions: Acute ischemic stroke is followed by a significant reduction of REM sleep in animals and humans. In humans, this reduction was linked with a bad stroke outcome; in addition, REM latency was found to be an independent predictor of stroke evolution. Potential explanations for this role of REM sleep in stroke are discussed.
Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique identifier: NCT01097967.
PMID: 30032306 [PubMed – as supplied by publisher]