Current Treatment Options in Neurology

, Volume 12, Issue 5, pp 379–395

Management of Sleep Disorders in Stroke

Sleep Disorders

Opinion statement

Scientific studies have proven a very strong association between stroke and obstructive sleep apnea (OSA). The prevalence of OSA is very high in patients with acute stroke, and untreated OSA is a stroke risk factor. In the stroke patient population, symptoms of OSA may atypically appear as isolated insomnia, hypersomnia, a dysfunction of circadian rhythm, a parasomnia, or a sleep-related movement disorder. Thus, we believe that in patients with acute stroke, OSA should be addressed first, using full in-laboratory, attended polysomnography (PSG), before other specific sleep disorders are aggressively addressed with specific therapeutic interventions. When OSA is diagnosed, supportive techniques including the application of continuous positive airway pressure (CPAP) therapy, positional therapies, or both should be considered first-line treatments. If OSA is ruled out by PSG, the therapeutic emphasis for sleep-related complaints is routinely based on instituting good sleep hygiene practices and using cognitive behavioral techniques (cognitive therapies, sleep restriction, stimulus control, and progressive relaxation therapies) because patients with stroke may be prone to the adverse effects of many of the medications that are otherwise routinely prescribed for a variety of specific sleep disorders.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Kyoung Bin Im
    • 1
  • Scott Strader
    • 2
  • Mark Eric Dyken
    • 3
  1. 1.Departments of Internal Medicine and PsychiatryUniversity of Iowa Roy J. and Lucille A. Carver College of MedicineIowa CityUSA
  2. 2.Clinical Neurophysiology, Department of NeurologyUniversity of Iowa Roy J. and Lucille A. Carver College of MedicineIowa CityUSA
  3. 3.Neurology, Department of Neurology Sleep Disorders CenterUniversity of Iowa Roy J. and Lucille A. Carver College of MedicineIowa CityUSA

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