Semin Neurol 2005; 25(1): 19-32
DOI: 10.1055/s-2005-867073
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Sleep and Stroke

Claudio L. Bassetti1
  • 1Department of Neurology, University Hospital, Zürich, Switzerland
Further Information

Publication History

Publication Date:
29 March 2005 (online)


More than 50% of stroke patients have sleep-disordered breathing (SDB), mostly in the form of obstructive sleep apnea (OSA). SDB represents both a risk factor and a consequence of stroke. The presence of SDB has been linked with poorer long-term outcome and increased long-term stroke mortality. Continuous positive airway presure is the treatment of choice for OSA. Oxygen and other forms of ventilation may be helpful in other (e.g., central) forms of SDB. SDB can improve spontaneously after stroke. About 20 to 40% of stroke patients have sleep-wake disorders (SWD), mostly in form of insomnia, excessive daytime sleepiness/fatigue, or hypersomnia (increased sleep needs). Depression, anxiety, SDB, stroke complications, and medications may contribute to SWD and should be addressed first therapeutically. Brain damage per se, often at thalamic or brainstem level, can be also a cause of persisting SWD. In these patients, hypnotics, dopeminergic agents, and stimulants (e.g., modafinil) can be attempted.


 Prof. Dr.
Claudio L Bassetti

Department of Neurology, University Hospital of Zurich

Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland