To consolidate knowledge on post-stroke insomnia (PSI) mechanisms and variability, and propose a clear, mechanism-informed treatment strategy that addresses individual patient needs.
Key Findings:
PSI is prevalent among stroke survivors and correlates with decreased rehabilitation participation and quality of life, which may hinder recovery and increase long-term disability.
PSI results from a complex interplay of neurobiological and psychosocial factors, including neurotransmitter disturbances and comorbidities such as pain and sleep-disordered breathing.
Current management of PSI often follows general insomnia protocols, lacking specificity for stroke populations, which may lead to suboptimal treatment outcomes.
Interpretation:
PSI is a multifaceted condition requiring tailored interventions that consider individual patient mechanisms, comorbidities, and specific treatment needs.
Limitations:
Variability in PSI definitions and treatment outcomes complicates research and clinical management, leading to inconsistent treatment approaches.
Insufficient objective sleep evaluations and brief follow-up periods hinder effective treatment assessment, making it difficult to gauge long-term efficacy.
Conclusion:
A mechanism-informed approach prioritizing objective sleep phenotyping and coordinated management of contributing factors, including comorbidities, is essential for improving PSI treatment.
