Nurs Res. 2022;71(6):483-490. doi: 10.1097/NNR.0000000000000611. Epub 2022 Aug 6.
A range of sleep disturbances and disorders are problematic in people after stroke; they interfere with recovery of function during poststroke rehabilitation. However, studies to date have focused primarily on the effects of one sleep disorder-obstructive sleep apnea (OSA)-on stroke recovery.
The study protocol for the SLEep Effects on Poststroke Rehabilitation (SLEEPR) Study is presented with aims of characterizing proportion of non-OSA sleep disorders in the first 90 days after stroke, evaluating the effect of non-OSA sleep disorders on poststroke recovery, and exploring the complex relationships between stroke, sleep, and recovery in the community setting.
SLEEPR is a prospective cohort observational study across multiple study sites following individuals from inpatient rehabilitation through 90 days poststroke, with three measurement time points (inpatient rehabilitation; i.e., ~15 days poststroke, 60 days poststroke, and 90 days poststroke). Measures of sleep, function, activity, cognition, emotion, disability, and participation will be obtained for 200 people without OSA at the study's start through self-report, capacity assessments, and performance measures. Key measures of sleep include wrist actigraphy, sleep diaries, overnight oximetry, and several sleep disorders screening questionnaires (Insomnia Severity Index, Cambridge-Hopkins Restless Legs Questionnaire, Epworth Sleepiness Scale, and Sleep Disorders Screening Checklist). Key measures of function and capacity include the 10-meter walk test, Stroke Impact Scale, Barthel index, and modified Rankin scale. Key performance measures include leg accelerometry (e.g., steps/day, sedentary time, upright time, and sit-to-stand transitions) and community trips via GPS data and activity logs.
The results of this study will contribute to understanding the complex interplay between non-OSA sleep disorders and poststroke rehabilitation; they provide insight regarding barriers to participation in the community and return to normal activities after stroke. Such results could lead to strategies for developing new stroke recovery interventions.
一系列睡眠障碍和紊乱在中风后人群中较为常见，这会影响中风后康复期间的功能恢复。然而，迄今为止的研究主要集中在一种睡眠障碍——阻塞性睡眠呼吸暂停（OSA）对中风康复的影响上。
本文呈现了 SLEep Effects on Poststroke Rehabilitation（SLEEPR）研究的研究方案，旨在描述中风后 90 天内非 OSA 睡眠障碍的比例，评估非 OSA 睡眠障碍对中风后恢复的影响，并在社区环境中探索中风、睡眠和恢复之间的复杂关系。
SLEEPR 是一项多站点前瞻性队列观察研究，在中风后通过住院康复跟踪患者 90 天，共三个测量时间点（住院康复时，即中风后约 15 天、60 天和 90 天）。通过自我报告、能力评估和表现测量，对 200 名无 OSA 的患者在研究开始时进行睡眠、功能、活动、认知、情绪、残疾和参与的测量。睡眠的关键测量包括腕部活动记录仪、睡眠日记、夜间血氧仪和几个睡眠障碍筛查问卷（失眠严重程度指数、剑桥-霍普金斯不宁腿症问卷、Epworth 嗜睡量表和睡眠障碍筛查清单）。功能和能力的关键测量包括 10 米步行测试、中风影响量表、巴氏指数和改良 Rankin 量表。关键表现测量包括腿部加速度计（例如，每天步数、久坐时间、直立时间和坐站转换次数）和通过 GPS 数据和活动日志记录社区出行。
这项研究的结果将有助于了解非 OSA 睡眠障碍与中风后康复之间的复杂相互作用；它们提供了有关中风后参与社区和恢复正常活动的障碍的见解。这些结果可能会导致开发新的中风康复干预策略。
