2021 NCPD Melanie Fleming

Dr Melanie Fleming

2021 Post-doctoral Non-clinical Fellowship

Investigating sleep as a potential means to improve learning and rehabilitation after stroke

Stroke is a leading cause of adult disability. Rehabilitation requires re-learning of movements and skills that have been affected by the stroke. In addition to improvements during practice sessions, re-learning also involves improvements between sessions. This is known as “motor consolidation” and previous research shows that this depends on sleep. However, sleep is commonly disrupted after stroke and poor sleep is associated with poor outcomes from rehabilitation. We think that poor sleep may impact on motor consolidation, and that this in turn affects recovery.

However, little is understood about why sleep is disrupted after stroke. Poor sleep may result from changes to the brain and could also be due to changes to behavioural routines, medication side effects, pain, and depression or anxiety. Determining what factors are associated with poor sleep after stroke could help clinicians to identify people at risk of long-term sleep complications, to be able to treat them early.

The studies in this fellowship aim to:

1) Understand how brain damage caused by stroke relates to sleep difficulties

2) Test if sleep can be improved for stroke survivors and if this leads to improvements in motor consolidation.

In study one I will measure sleep quality in stroke survivors and test how sleep quality relates to brain damage detected on brain scans. In study two, stroke survivors will be given access to an online sleep improvement programme (Sleepio). I will test for improvements in sleep quality and changes in motor consolidation after completion of the Sleepio programme.

Together, these studies will help us to understand the role of sleep in rehabilitation after stroke and help us to design treatments to improve sleep and recovery.


Improving sleep and learning in rehabilitation after stroke, part 2 (INSPIRES2): study protocol for a home-based randomised control trial of digital cognitive behavioural therapy (dCBT) for insomnia

Weightman M, Robinson B, Fallows R, Henry AL, Kyle SD, Garratt E, Pick A, Teal R, Ajina S, Demeyere N, Espie CA, Seymour B, Johansen-Berg H, Fleming MK

BMJ Open. 2023 Apr 6;13(4):e071764. doi: 10.1136/bmjopen-2023-071764