Abstract WP172: Significance of sleep impairment after acute ischemic stroke: results of the OPTIMISTmain study

Background: Sleep impairment is common in patients after acute ischemic stroke (AIS) but few studies have examined the associated predictor variables and prognostic significance. Aims: To determine the factors associated with sleep impairment in patients with mild to moderate AIS who participated in the main Optimal Post rTpa-IV Monitoring in Ischemic Stroke Trial (OPTIMISTmain). Methods: OPTIMISTmain was an international, multicenter, stepped wedge, cluster randomized non-inferiority controlled trial with blinded outcome assessment, that aimed to determine the safety and effectiveness of low-intensity versus standard monitoring in stable thrombolysis-treated AIS patients. Sleep-related impairment was assessed at 7 days with an eight-item short-form questionnaire referred to as The Patient-Reported Outcome Measurement Information System (PROMIS). The primary outcome was unfavorable functional recovery (mRS 2-6) at 90 days. Secondary outcomes include death; death or dependency (mRS 3-6) and EQ-5D-5L visual analogue scale score. Total raw scores were converted to T-score , where >50 (mean for US general population) indicated sleep-related impairment. Analysis used logistic or linear regression models with adjustment for study design and potential confounders (P