This should be able to be applied to stroke. But extremely unlikely since I have seen no indication that there is any strategy in stroke for helping survivors recover.
http://dgnews.docguide.com/new-recommendations-link-better-sleep-improved-concussion-outcomes?
A national group of sleep and brain injury specialists recommends
specific steps to test and develop sleep-related treatments to improve
the outcome of mild traumatic brain injury (mTBI).
The recommendations, developed by a sleep specialist at the
University of Maryland School of Medicine, Baltimore, Maryland, along
with experts from medicine, the military, and private industry, appear
online ahead of the print edition of the journal Neurotherapeutics.
“Clinical practice guidelines in mTBI or concussion are woefully
lacking, despite spending tens of millions of dollars over the past
decade,” said Emerson M. Wickwire, PhD, University of Maryland. “We
still are not very good at improving long-term outcomes and reducing the
prevalence of patients who end up with long-term effects of
concussion.”
“Leaders in TBI identified 4 topical areas that may be potential
pathways to improve outcomes in mTBI: neuroinflammation,
neuropsychiatric disease, chronic pain, and of course, disturbed sleep,”
he said.
Wickwire says sleep and brain injury appear to share several overlapping brain circuits.
“Structures damaged in brain injury may cause alterations in
sleep/wake cycles,” he said. “At the same time, sleep disturbances,
which are reported by roughly half of people with brain injury, worsen
quality of life, make treatment more difficult, and may well change the
way the brain heals itself.”
Given the shared neurophysiologic underpinnings of sleep and mTBI,
Wickwire said disturbed sleep and clinical sleep disorders represent
treatment targets that can be modified to improve outcomes and quality
of life in mTBI.
The group has developed several recommendations to improve sleep
outcomes in patients with mild TBI. They include data repositories where
sleep-specific information could be incorporated into existing TBI
repositories and aggregated across multiple centres; serial assessment
of mild TBI patients at various time intervals post-injury to help
identify those who may develop long-term sleep disorders; research
targeting treatments for mTBI-specific sleep disorders; sleep-specific
education for head injury medical professionals; and increased access to
sleep treatment services at head trauma centres.
Regarding treatment, Wickwire said there are many questions to be answered.
“On the one hand, is sleep in and of itself therapeutic and can we
manipulate sleep through pharmacologic or other means, in a way that
will improve healing and recovery following brain injury?” he said.
A second group of questions deals with clinical sleep disorders --
insomnia, obstructive sleep apnoea, circadian rhythm disorders, which
affect sleep scheduling, parasomnias, such as sleep walking, and fatigue
that develops following brain injury.
“We have effective treatments for these sleep disorders in
non-brain-injured patients, but we need to adapt these treatments to
patients with mTBI, who might have unique needs,” said Wickwire. “There
may also be sleep problems that are unique to patients with mTBI for
which there are no currently effective treatments.”
“Success at improving outcomes in patients with mild traumatic brain
injury will require sustained effort on many fronts, and from a variety
of disciplines,” said E. Albert Reece, MD, University of Maryland School
of Medicine. “The recommendations in this paper set forth a clear
pathway to reach that goal.”
SOURCE: University of Maryland School of Medicine
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