Background: Sleep is essential for neurological recovery, yet it remains under-recognised in stroke care. Disrupted sleep is common among stroke patients and may hinder recovery or worsen cardiovascular risk.

Aim: This study explores how sleep duration and quality vary with age before, during, and after hospitalisation for stroke.

Methods: We conducted a retrospective cohort study at Wrexham Maelor Hospital using data from the Sentinel Stroke National Audit Programme (SSNAP), electronic health records from the Welsh Clinical Portal, and discharge summaries from the EPOC system between March 2024 and March 2025. Sleep was assessed through structured post-discharge questionnaires that captured self-reported sleep duration and perceived quality across three phases: prestroke, during hospital admission, and post-discharge. Participants were divided into three age groups: 18–49, 50–74, and 75+ years.

Results: Clear age-dependent differences in sleep duration and quality were evident prior to, during, and following hospitalisation for stroke. Patients aged 50–74 years reported the longest sleep durations before stroke, with a mean of 7.10 hours, while younger participants (18–49 years) had the most substantial post-discharge recovery at 7.30 hours. Older adults (75+ years) consistently had the shortest sleep durations throughout the study period; the mean values during prestroke, inpatient admission, and post-discharge were 6.96 hours, 5.72 hours, and 6.82 hours, respectively, with little improvement in sleep quality. All age groups experienced sleep declines during hospitalisation, with varying degrees of recovery afterward.

Conclusion: Sleep disruption is a widespread problem in stroke care, particularly among older patients who face persistent deficits. These findings emphasise the importance of routine sleep assessments and age-appropriate interventions. Integrating sleep health into comprehensive, patient-centred stroke rehabilitation may improve recovery and long-term well-being.