Qualidade do sono e cronotipo como fatores prognósticos na recuperação neurológica de pacientes com Acidente Vascular Cerebral

Abstract

Stroke is considered a neurological syndrome, with high incidence and prevalence worldwide. Originated by a dysfunction in the brain circulation, which alters its dynamics generating diverse symptoms, and represents the main cause of neurological sequelae. Many risk factors contribute to the development of stroke, including hypertension, diabetes, dyslipidemia, and advanced age. However, recent studies have shown that sleep quality is closely related to the incidence of stroke and its prognosis. The present study sought to evaluate sleep quality and chronotype in patients with ischemic stroke, whether or not submitted to thrombolytic treatment. To this end, 35 stroke patients treated at the Stroke Unit of the State General Hospital were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and the Munich Chronotype Questionnaire (MCTQ) to determine sleep quality and the chronotype respectively. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) standard clinical scale and Modified Rankin Scale (mRANKIN) at two moments, admission and hospital discharge. Results show that NIHSS and mRANKIN were significantly reduced at discharge compared to admission. The application of the PSQI showed that 22 (62.9%) stroke patients had poor sleep quality and 13 (37.1%) patients had indicative of sleep disturbance. There was a weak but significant negative correlation between the overall PSQI value and the age of the patients. Among the 35 patients, 21 of them (60%) were classified as morning chronotype, 7 patients (20%) as afternoon chronotype and 7 patients (20%) as an intermediate chronotype. There was a significant difference with a positive correlation between MCTQ and mRANKIN scale at discharge. Thus, it can be concluded that the quality of sleep and the chronotype of patients affect the degree of severity and serve as prognostic factors in the neurological recovery of stroke patients.