Stroke is defined as a clinical syndrome resulting from reduced blood flow to brain structures, with development of focal and global signs of brain deficit, with no apparent cause other than vascular. Stroke can be classified as ischemic or hemorrhagic, with the first one being more prevalent. Wake-up Stroke is a type of ischemic stroke, in which the first stroke symptoms are noticed right after waking up. Studies indicate that Wake-up Stroke may be related to obstructive sleep apnea, the most prevalent sleep disorder in post-stroke individuals and worse post-stroke outcomes.

To investigate differences between post-stroke groups in the chronic stage that had or did not have Wake-up Stroke in relation to quality of life, walking capacity and functional status.

Exploratory cross-sectional study. Inclusion criteria were individuals aged 20 or over, diagnosis of ischemic stroke, post-stroke time greater or equal to 6 months, ability to walk independently and absence of cognitive alterations. The stroke was classified as a Wake-up Stroke if the first signs of the stroke were noticed shortly after awakening. The dependent variables were quality of life, walking capacity and functional status, measured by EuroQol, Six-Minute Walk Test and Modified Ranking Scale respectively. The independent t test was used to compare the Wake-up Stroke and non-Wake-up Stroke groups, considering a significance level of 5%. Statistical tests were performed using SPSS program (version 19.0).

The study included 52 individuals with a mean age of 61 years and mean duration of 53 months. 13 (25%) individuals had a stroke classified as Wake-up Stroke. Most of the participants were male (55.8%), did not practice regular physical exercise (80.8%), had systemic arterial hypertension (80.8%) and were classified as intermediate or high risk for obstructive sleep apnea (82.7%). The analysis showed that there was no significant difference between groups regarding quality of life (p<0.576), walking ability (p<0.815) and functional status (P<0.645).

There was no difference between the groups that had or did not have Wake-up Stroke in terms of quality of life, walking ability and functional status. However, it is important to consider that 25% of the sample showed the first signs of stroke upon awaking and that more than 80% of the individuals were classified as intermediate or high risk for obstructive sleep apnea. Therefore, further studies are needed for a better understanding of Wake-up Stroke and its relationship with the rehabilitation process and sleep disorders.

Longitudinal studies with larger samples are still needed to confirm the findings of the present study, as well as to investigate the relationship between Wake-up Stroke and other important post-stroke outcomes.