This Article Full Text Full Text (PDF) All Versions of this Article: 36/3/578    most recent 01.STR.0000154862.33213.73v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schuiling, W. J. Articles by de Weerd, A. W. Search for Related Content PubMed PubMed Citation Articles by Schuiling, W. J. Articles by de Weerd, A. W. Pubmed/NCBI databases Medline Plus Health Information Sleep Disorders Related Collections Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage

(Stroke. 2005;36:578.)
© 2005 American Heart Association, Inc.

Original Contributions

Disorders of Sleep and Wake in Patients After Subarachnoid Hemorrhage

From the Department of Neurology and Clinical Neurophysiology (W.J.S., A.W.d.W.), the Department of Neurosurgery (R.W.), Medical Center Haaglanden, Westeinde Hospital, the Netherlands; and the Department of Neurology (G.J.E.R.), University Medical Center Utrecht, the Netherlands.

Correspondence to Dr W. J. Schuiling, Department of Neurology, Medical Center Leeuwarden, P.O. Box 888, 8901 BR Leeuwarden, the Netherlands. E-mail wjschuiling{at}planet.nl

Background and Purpose— To determine the frequency and severity of disorders of sleep and wake and their relation to the quality of life (QoL) in patients who have survived an episode of subarachnoid hemorrhage (SAH).

Methods— In a prospectively collected, consecutive series of 89 patients, 83 patients completed validated and frequently used questionnaires for the assessment of disorders of sleep and wake (SDL and Epworth Sleepiness Score) at least 1 year (range, 1 to 3.4 years) after the SAH. We used the modified Rankin scale for functional outcome and Short Form 36 (SF-36) to assess QoL. We related the occurrence of severe problems with sleep (insomnia or excessive daytime sleepiness score or both 3 on SDL) to functional outcome and to the QoL scores and compared the latter scores with data from a Dutch reference population. In a subset of 20 patients with severe problems with sleep, we performed polysomnographic and actigraphic studies at home during 48 hours.

Results— Twenty eight (34%) patients had severe problems with sleep. Frequently reported problems are initiating (25%) or maintaining (31%) sleep, difficulty returning (28%) asleep, tiredness (31%), and excessive sleepiness during the day (6%). QoL was considerably reduced in patients with severe problems with sleep. During the sleep monitoring studies, severe sleep fragmentation, sleep apnea, restless legs syndrome/periodic limb movement disorder, or a combination of these disorders of sleep and wake occurred in 19 of 20 patients.

Conclusion— Many patients who have survived an episode of SAH have disorders of sleep and wake, which are related to the QoL.

Key Words: outcome • quality of life • sleep • subarachnoid hemorrhage

This article has been cited by other articles:

				A. A. van der Klaauw, O. M. Dekkers, A. M. Pereira, K. W. van Kralingen, and J. A. Romijn Increased Daytime Somnolence despite Normal Sleep Patterns in Patients Treated for Nonfunctioning Pituitary Macroadenoma J. Clin. Endocrinol. Metab., October 1, 2007; 92(10): 3898 - 3903. [Abstract] [Full Text] [PDF]