title: Sleep disturbance and deficits of sustained attention following stroke.
abstract: OBJECTIVE
  To simultaneously investigate the prevalence of and impact that the poststroke complications of daytime sleepiness, poor sleep quality, depression, and fatigue may be having upon deficits of sustained attention, as assessed using the Psychomotor Vigilance Task (PVT).
  
  
  METHODS
  Twenty-two patients with stroke (mean age: 68.23 ± 12.17 years) and 20 healthy control participants (mean age: 68.1 ± 9.5 years) completed subjective measures of daytime sleepiness, sleep quality, fatigue, and depression and an objective measure of sustained attention as assessed using the PVT.
  
  
  RESULTS
  Patients with stroke compared to controls showed heightened levels of fatigue (p = .001, η(2) = .29) and depression (p = .002, η(2) = .23), plus greater deficits of sustained attention as reflected by poorer performance across all PVT outcome measures including: slower mean reaction times (p = .002, η(2) = .22); increased number of lapses (p = .002, η(2) = .24); and greater variability in reaction time (RT) responses (p = .016, η(2) = .15). Reaction time distribution analysis suggested that daytime sleepiness and sleep quality had little influence across PVT performance; however, depressive symptomology was associated with longer RT responses, indicative of inattention, and fatigue impacted upon the entire distribution of PVT responses.
  
  
  CONCLUSIONS
  PVT performance illustrated significant deficits across the domain of sustained attention for patients with stroke in comparison to healthy controls, in terms of inattention as well as slower sensory-motor speed. The common poststroke complications of depressive symptomology and fatigue appear to be associated with these deficits in sustained attention, warranting further investigation.
authors.affiliation: a School of Psychological Sciences , Monash University , Clayton, VIC , Australia.
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Pearce
authors.affiliation: a School of Psychological Sciences , Monash University , Clayton, VIC , Australia.
authors.forename: Renerus J
authors.initials: RJ
authors.lastname: Stolwyk
authors.affiliation: b Epworth-Monash Rehabilitation Medicine Unit , Monash University , Melbourne, VIC , Australia.|c Rehabilitation and Aged Services, Medicine Program, Monash Health , Melbourne, VIC , Australia.|d School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine , Monash University , Melbourne, VIC , Australia.
authors.forename: Peter W
authors.initials: PW
authors.lastname: New
authors.affiliation: a School of Psychological Sciences , Monash University , Clayton, VIC , Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Anderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011596:Psychomotor Disorders / Q000209:etiology; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000145:classification / Q000209:etiology*; D020521:Stroke / Q000150:complications*
keywords: Attention; Depression; Fatigue; Sleep; Stroke