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NON-PHARMACOLOGICAL INTERVENTIONS FOR ALLEVIATING FATIGUE AND PROMOTING SLEEP IN PEOPLE WITH STROKE: A META-ANALYSIS
Abstract
Background and Aims
Treating predisposing factors of fatigue such as sleep quality may help reduce fatigue in people with stroke. In the last decade, more interventions have been developed for stroke survivors having fatigue, but the effects of non-pharmacological interventions on fatigue and sleep quality among this population remains unclear. This review aimed to evaluate the effects of non-pharmacological interventions on fatigue and sleep quality among people with stroke.
Methods
We searched the randomized controlled trials about non-pharmacological interventions for alleviating fatigue and promoting sleep in seven databases. The search included the clinical trial registries, reference lists and the forward citations of the included publications. The standardized mean difference (SMD) or mean difference (MD) of fatigue and/or sleep variables at different time points post-intervention were/was estimated using random effects models.
Results
Seventeen studies (n=1,079) were analyzed. Non-pharmacological interventions were summarized into four types: physical intervention, cognitive intervention, oxygen therapy, and traditional Chinese medicine. Compared to the control groups, non-pharmacological interventions significantly improved sleep quality (SMD= -0.76, 95% CI= -1.27 to -0.25) and insomnia (MD= -4.19, 95% CI= -5.77 to -2.60) but not fatigue, sleep apnea, and sleepiness immediately post-intervention. Non-pharmacological interventions had insignificant short and medium-term effects on fatigue, but their longer-term effects on sleep quality, insomnia, and sleepiness were inconclusive.
Conclusions
Non-pharmacological interventions could improve sleep quality and insomnia immediately post-intervention among people with stroke. Further robust studies are needed to determine their immediate and longer-term effects on fatigue and sleep.