Hypersomnolence and fatigue in patients in the acute period of ischemic stroke

INTRODUCTION. Fatigue after stroke has attracted research attention, but there is still insufficient evidence to estimate its prevalence and identify factors for its variability. As this condition has multiple implications for stroke survivors and the lives of their families, there is a need to find evidence regarding the causal relationship of fatigue with other post-stroke conditions.

AIM. To evaluate the dependence of the degree of hypersomnolence and fatigue on the severity, volume, localisation of the lesion focus and subtype of ischemic stroke (IS) according to the TOAST classification and to study the influence of neurological deficit on the severity of fatigue in patients in the acute period of IS.

MATERIALS AND METHODS. 80 patients in the acute period of IS were included in the study. During the examination, the subtype, basin and volume of the ischaemic focus were recorded. Fatigue was assessed using FIS and FSS scales, sleepiness was assessed using a sleep diary, ESS and KSS scales, and stroke severity was assessed using NIHSS, Rankin, Bartel, and Rivermead scales. Statistical data processing was performed using StatPlus Mac software package (USA). The significance level for statistical hypothesis testing was taken as p 0.05.

RESULTS. Hypersomnolence was detected in 37 patients, predominantly with unspecified subtype of IS, without dependence on the volume of the focus and severity of IS. To a greater extent, drowsiness was demonstrated in patients with right-sided localisation of the ischemia focus. Fatigue was observed in 17 patients regardless of the subtype of IS, localisation and volume of IS. The level of fatigue was higher in patients with greater neurological deficit and less mobility. No association of fatigue with the presence or absence of hypersomnolence was found.

CONCLUSION. The established correlation of hypersomnolence with the subtype of IS, affected hemisphere can serve as a reference point for predicting the outcomes of IS and developing individual patient treatment tactics. The revealed regularities, the discrepancy of data on the dependence of fatigue and sleepiness severity on the subtype of IS and localisation of the lesion focus allow us to assert the possibility of differentiating the concepts of fatigue and sleepiness.

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