Feasibility Of Sleep Treatment Education in Stroke Rehabilitation Settings (FOSTERS)

Usual care prior to delivery of sleep package

Usual care plus sleep package

Staff and patients will receive sleep resources and staff will receive sleep training

Staff sleep training implementation

Proportion of staff who received the sleep package rating the package as useful, using a likert scale 4-point rating from 1=no definitely not, to 4=yes definitely

Proportion of staff who received the sleep package rating the package as relevant, using a 4-point likert scale from 1=no definitely not, to 4=yes definitely

Proportion of staff who received the sleep package rating the package as appropriate, using a 4-point likert scale from 1=not appropriate at all, to 4=very appropriate

Proportion of patients who received the sleep package rating the package as useful. 10-point Likert scale rating for usefulness of resources, from 1=not useful at all, to 10=very useful.

Likert scale rating of how acceptable they found measures that staff were using to try to support their sleep, from 1=not acceptable at all, to 10=very acceptable.

Sleep assessed using the Sleep Condition Indicator questionnaire (SCI), from 0-32, with higher values indicating better sleep

Assessed using actigraphy (wearable activity monitor) over the duration of their stay in hospital from enrolment to discharge. Higher values indicate more disrupted (worse) sleep. The minimum value is 0. There is no specified maximum value. According to the manual for the software which does the calculation the definition of sleep fragmentation index is "the sum of the Mobile time (%)' and the 'Immobile bouts <=1min".There are no units associated with sleep fragmentation.

Sleep assessed using the Sleep related impairment questionnaire (SRI). Each question is scored from 1 to 5, yielding a raw total sum score from 8 to 40. Higher raw numbers mean worse daytime impairment. Raw scores are translated into a T-score using official lookup tables. Interpreting the T-Score: 50 or lower: Normal or better-than-average wakefulness/55 to 59 (0.5 to 1.0 SD above mean): Mild sleep-related impairment/60 to 69 (1.0 to 2.0 SD above mean): Moderate sleep-related impairment/70 or higher (2.0+ SD above mean): Severe sleep-related impairment.

Sleep assessed using the Sleep disturbance questionnaire (SD). 5-point Likert scale (1 = never to 5 = always) covering the past 7 days. Sum the raw scores (range 8-40) and use a standard look-up conversion table to change the raw total into a standardized T-score (mean = 50, standard deviation = 10). T-Score Interpretation: < 55: None to slight sleep disturbance/55.0 - 59.9: Mild sleep disturbance/60.0 - 69.9: Moderate sleep disturbance/70 and over: Severe sleep disturbance

Sleep assessed using the Richards-Campbell Sleep questionnaire. Scored by measuring 5 visual analog scale items from 0 to 100 millimeters. Each item score is summed and divided by 5 to yield a total score from 0 (worst sleep) to 100 (best sleep), with scores under 50 indicating poor sleep.

Sleep assessed using the sleep environment questionnaire (ASE). The Assessment of Sleep Environment (ASE) is a 13-item self-report questionnaire. Each item is rated on a 4-point Likert scale from 0 to 3 ("strongly disagree" to "strongly agree"). Summing all items yields a total score from 0 to 39, where higher scores reflect a more disruptive, poorer sleep environment.

Mood assessed using the Patient Health Questionnaire (PHQ8). Each item is rated from 0 to 3 based on how often symptoms occurred over the past two weeks. Total scores range from 0 to 24. 0-4: No significant depressive symptoms/5-9: Mild symptoms/10-14: Moderate symptoms (a score of 10 or greater often indicates probable major depression)/15-19: Moderately severe symptoms/20-24: Severe symptoms

Fatigue assessed using the Fatigue Severity Scale (FSS). Scores are evaluated by calculating the total sum (9 to 63) or the average mean (1 to 7). A mean score of 4.0 or higher (or a total sum of 36 or more) indicates clinically significant fatigue