Objective: The study aims to examine sleep quality in stroke patients, and to identify effects of functional and emotional state and motor recovery on the sleep quality.

Material and Method: 62 patients having hemiplegia as a result of cerebrovascular accident and 62 controls were included in this study. Sociodemographic data of study group and clinical characteristic of patients were recorded. The Barthel Index (BI) and the Functional Ambulation Category (FAC) scale were employed to assess the functional state of patients. Emotional state of the patients was evaluated by the Hospital Anxiety and Depression Scale (HADS), while Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Functional status, motor impairment and emotional state were determined as independent variables, and multiple regression analysis was used to predict sleep quality.

Results: Patients had significantly higher scores in the subscores and total scores of PSQI in comparison with the controls (p<0.001). The HADS anxiety and depression score were correlated with PSQI total score in the patients (p<0.01). BI was also significantly negatively correlated with PSQI total score. The multivariate regression analyses indicated that depression state was the most significant factor to predict sleep quality (p<0.01).

Conclusion: Our study showed that stroke patients have a significantly poorer sleep quality than the controls. The impaired sleep quality appears to be related with the emotional state and physical disability. Because our study revealed that depression is the most significant factor that determines sleep quality, we consider that early diagnosis and treatment of depression is vital in the improvement of sleep quality of stroke patients.