Sleep and neurovascular disease

Sleep has a complex relationship with human health. Impairments in sleep represent a common, potentially modifiable risk factor for incident stroke, and functional recovery after acute stroke. Research on the association of sleep with stroke (risk and clinical outcome) present challenges, and previous observational research looking at the association between sleep disturbance and stroke has been limited in scope and size, and not studied in many regions of the world. The phenotypes of sleep disturbance are varied, requiring multi dimensional measurement among diverse populations. Moreover, there are challenges to determining the independent association of sleep impairments and stroke, due to the confounding effect of numerous factors. Medications to manage sleep impairments are prescribed commonly after stroke, which may have important implications for stroke recovery. The goals of this research thesis are to: a) determine the association of sleep impairments with odds of acute stroke, and functional outcomes at 1-month after stroke; b) to systematically review the literature to determine whether interventions to improve sleep are associated with changes in vascular risk factors; c) to explore whether patients presenting with ‘wake-up’ acute stroke differed from those presenting with symptoms while awake, in terms of demographic and medical characteristics, clinical presentation, stroke aetiology and access to care in different regions of the world; and d) to describe hypnotic prescribing practices following stroke, and their association with adverse clinical events and mortality.

Publisher

NUI Galway

Rights

Attribution-NonCommercial-NoDerivs 3.0 Ireland
CC BY-NC-ND 3.0 IE

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Collections

University of Galway Theses (PhD Theses)