Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
Arch Phys Med Rehabil. 2011 Dec;92(12):2025-7. doi: 10.1016/j.apmr.2011.06.030.
To evaluate the relationship between insomnia and suicidality (SI) in Chinese patients with first or recurrent stroke.
Cross-sectional survey.
Acute stroke unit of a general hospital.
Patients (N=787) with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong.
Not applicable.
Suicidality (SI) was assessed with the Geriatric Mental State Examination at 3 months after subjects' index stroke. Insomnia symptoms were evaluated with a standard insomnia questionnaire. The association between insomnia symptoms and SI was examined and adjusted for potential confounders, including age, sex, marital status, previous stroke, depression, fatigue, Mini-Mental State Examination score, and neurologic deficits measured with the National Institutes of Health Stroke Scale.
Eighty-seven patients (11.1%) were found to have SI (SI group). Frequent awakening was significantly more common in the SI group than in the non-SI group and remained a significant predictor of SI in forward logistic regression analysis (odds ratio, 1.7) after adjusting for possible confounders.
These findings should alert clinicians to the potential danger of insomnia and the importance of its early identification and treatment in stroke patients.
评估中国首发或复发性脑卒中患者失眠与自杀意念（SI）的关系。
横断面调查。
综合医院急性脑卒中病房。
香港某大学附属医院急性脑卒中病房收治的急性缺血性脑卒中患者（N=787）。
无。
在受试者首发脑卒中后 3 个月，采用老年精神状态检查评估自杀意念。采用标准失眠问卷评估失眠症状。在调整了年龄、性别、婚姻状况、既往脑卒中、抑郁、疲劳、简易精神状态检查评分和美国国立卫生研究院脑卒中量表测量的神经功能缺损等潜在混杂因素后，探讨了失眠症状与 SI 的关系。
87 例患者（11.1%）出现 SI（SI 组）。与非 SI 组相比，SI 组频繁觉醒更为常见，且在调整了可能的混杂因素后，频繁觉醒仍然是 SI 的显著预测因素（比值比，1.7）。
这些发现应引起临床医生的注意，即失眠可能存在潜在危险，对于脑卒中患者，早期识别和治疗失眠非常重要。
