The Potential Role of Sleep in Post-stroke Motor Learning

Abstract

Background: Stroke is the leading cause of adult-onset disability in the United Kingdom, and individuals who survive a stroke frequently encounter challenges in reacquiring motor abilities, which has a substantial influence on their overall well-being. Introduction: In the pursuit of safe and efficacious motor recovery, scientific research has attempted to identify key variables that influence movement rehabilitation. In recent years, promising (albeit limited) evidence suggests that sleep is one key modulator of motor learning and potentially, therefore, post-stroke rehabilitation outcomes. The rationale underpinning this review was to examine, synthesize and discuss research pertaining to sleep and post-stroke motor recovery, to determine whether and how this relationship may be working. Results: Sleep-induced motor learning has two distinct phases, sleep before learning (SBL) and sleep after learning (SAL). These stages facilitate consolidation of memories and reinforce the connections between different regions of the cerebral cortex, thereby decreasing the need for the medial temporal lobe (MTL) to bind information. Studies have shown that stroke patients exhibit increased tracking accuracy after a night of sleep compared to those who do not sleep. Sleep disruptions impair functional recovery among stroke survivors, particularly those who suffered from moderate strokes. Poor sleep quality is associated with hindered post-stroke motor recovery, while sedatives do not significantly improve sleep or rehabilitation outcomes and may have detrimental effects on memory and neuronal connections. Conclusion: In conclusion, existing research indicates a promising role of sleep for post-stroke motor learning.