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There is evidence that circadian misalignment is linked with an increased risk of stroke and that circadian preference is linked with rehabilitation outcomes after stroke. Circadian preferences refer to preferences based on individuals' characteristics in respect of the timing of physiological functions that are typically assessed by self-report questionnaires. This study set out to explore this relationship by examining whether there was an association between circadian preference and stroke characteristics in a sample of stroke outpatients, considering the time of stroke onset, the topography of the stroke and the resulting disability. We also examined whether sleep complaints (snoring, insomnia, sleep apnea) were associated with circadian preferences (i.e., morning-, evening-, and intermediate-types). We also compared circadian preferences and comorbidities in this sample, matched by age and sex, with those of healthy controls who took part in an epidemiological study (EPISONO) comprising a representative sample of the population of the city of São Paulo, Brazil. Most of our sample in both groups were morning-type, and in the stroke group, ischemic stroke was the most common type. There was an increased risk for sleep apnea among evening-types, and a higher prevalence of diabetes in the evening- and intermediate-types. We found no association between circadian preference and the time of stroke onset, or with wake-up stroke. We found a low prevalence of evening-type participants in our sample of controls (2.9%) and in the stroke group (1.7%). This investigation showed a similar circadian preference (morning-types) in stroke outpatients and the general population.

Background: Loss of teeth has been associated with neurological and sleep disorders. It is considered to be a predictor of stroke and leads to modifications of airway patency and predisposition to obstructive sleep apnea. Objective: To investigate sleep quality, risk of obstructive sleep apnea and excessive sleepiness among post-stroke patients with tooth loss attending the Neurovascular Clinic of the Federal University of São Paulo. Methods: The prevalence rates of different types of stroke were assessed among 130 patients with different degrees of tooth loss, along with the presence of sleep disturbances, risk of obstructive sleep apnea and excessive daytime sleepiness. Results: The prevalence of ischemic stroke was 94.6%, with either no significant disability or slight disability. Our sample had poor sleep quality, and a high risk of obstructive sleep apnea, but without excessive daytime sleepiness. Half of our sample had lost between 9 and 31 teeth, and more than 25% had edentulism. The majority used full removable dental prostheses, and more than half of these individuals slept without removing the prosthesis. Conclusions: We found high prevalence of poor sleep quality and high risk of obstructive sleep apnea among post-stroke patients with tooth loss. This indicates the need for further studies on treating and preventing sleep disturbances in stroke patients with tooth loss. RESUMO Antecedentes: A perda de dentes tem sido associada a distúrbios neurológicos e do sono. É considerada um preditor de acidente vascular cerebral (AVC), com modificações na permeabilidade das vias aéreas e predisposição à apneia obstrutiva do sono. Objetivo: Investigar a qualidade do sono, o risco de apneia obstrutiva do sono e a sonolência excessiva em pacientes pós-AVC com perda dentária, atendidos na Clínica Neurovascular da Universidade Federal de São Paulo. Métodos: O estudo avaliou a prevalência de diferentes tipos de AVC em 130 pacientes com diferentes graus de perda dentária e a presença de distúrbios do sono, risco de apneia obstrutiva do sono e sonolência excessiva. Resultados: A prevalência de AVC isquêmico foi de 94,6%, sem deficiência significativa ou deficiência leve. Nossa amostra tinha má qualidade de sono e alto risco de apneia obstrutiva do sono, sem sonolência diurna excessiva. Metade de nossa amostra perdeu entre nove e 31 dentes, e mais de 25% tiveram edentulismo. A maioria usava próteses dentárias totalmente removíveis e, desses pacientes, mais da metade dormia com elas. Conclusões: Encontramos alta prevalência de má qualidade do sono e alto risco de apneia obstrutiva do sono em pacientes pós-AVC com perda dentária. Isso indica a necessidade de mais estudos sobre o tratamento e a prevenção de distúrbios do sono em pacientes com AVC e perda dentária.