Association Between Post-Stroke Fatigue and Sleep Quality Among Patients with Stroke

Abstract

Background: Fatigue and sleep disturbance commonly coexist after stroke, but evidence from Indonesian rehabilitation settings remains limited. Objectives: To examine the association between post-stroke fatigue and sleep quality in a rehabilitation unit. Methods: A cross-sectional observational study included 51 post-stroke patients at Jakarta Islamic Hospital, selected through purposive sampling. Fatigue and sleep quality were assessed using the Fatigue Severity Scale and Pittsburgh Sleep Quality Index. The reported fatigue categories were mild and moderate, and sleep quality was classified as good or poor. Pearson’s chi-square test and an unadjusted prevalence odds ratio (POR) with a 95% confidence interval (CI) were used. Results: Mean age was 54.43 ± 12.49 years; 58.8% were male and 64.7% had ischemic stroke. Moderate fatigue and poor sleep quality were reported by 68.6% and 60.8%, respectively. Poor sleep occurred in 6/16 (37.5%) patients with mild fatigue and 25/35 (71.4%) with moderate fatigue (χ²(1) = 5.303; p = 0.021). The odds of poor sleep were 4.167 times those in the mild-fatigue group (POR = 4.167; 95% CI = 1.194-14.541). Conclusion: Fatigue category was associated with sleep quality in this sample. The unadjusted, imprecise estimate supports concurrent screening and further clinical assessment, while causality and intervention effects require additional investigation.