Tang Wai-Kwong, Grace Lau Chieh, Mok Vincent, Ungvari Gabor S, Wong Ka-Sing
Top Stroke Rehabil. 2015 Jun;22(3):201-7. doi: 10.1179/1074935714Z.0000000026. Epub 2015 Apr 23.
Insomnia is a common complaint in stroke survivors. Insomnia after stroke is correlated with physical disability, dementia, anxiety, depression, and fatigue. However, the influence of insomnia following stroke on health-related quality of life (HRQoL) has not been investigated.
The current study aimed to examine the effect of insomnia on HRQoL in stroke survivors 3 months after their index stroke over and above confounding variables.
Three hundred and thirty-six patients were recruited from the acute stroke unit in a regional hospital in Hong Kong. Insomnia was ascertained by a single item on a locally validated, seven-item insomnia questionnaire. HRQoL was measured by the total score and the 12 domain scores of the Stroke Specific Quality of Life (SSQoL) scale. Demographic and clinical characteristics were obtained using the following scales: National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS).
Forty-four percent of stroke survivors reported experiencing insomnia in the past month; they were more likely to be female and to have a higher GDS score. The insomnia group had significantly lower overall SSQoL, energy and thinking scores after adjusting for sex, BI, and GDS scores.
The findings show that stroke survivors who experienced insomnia had a reduced overall HRQoL and were impaired in the energy and thinking domains of HRQoL. Early screening for sleep disturbance would be beneficial to prevent later development of post-stroke insomnia. Pharmacological and non-pharmacological interventions are suggested to improve HRQoL in stroke patients with insomnia.
失眠是中风幸存者常见的主诉。中风后的失眠与身体残疾、痴呆、焦虑、抑郁和疲劳相关。然而，中风后失眠对健康相关生活质量（HRQoL）的影响尚未得到研究。
本研究旨在探讨失眠对中风幸存者在首次中风3个月后HRQoL的影响，同时考虑混杂变量。
从香港一家地区医院的急性中风单元招募了336名患者。通过一份经过本地验证的七项失眠问卷中的一个单项来确定失眠情况。HRQoL通过中风特异性生活质量（SSQoL）量表的总分和12个领域得分来衡量。使用以下量表获取人口统计学和临床特征：美国国立卫生研究院卒中量表（NIHSS）、巴氏指数（BI）、简易精神状态检查表（MMSE）和老年抑郁量表（GDS）。
44%的中风幸存者报告在过去一个月中经历过失眠；他们更可能是女性且GDS得分更高。在调整性别、BI和GDS得分后，失眠组的总体SSQoL、精力和思维得分显著更低。
研究结果表明，经历失眠的中风幸存者总体HRQoL降低，且在HRQoL的精力和思维领域受损。早期筛查睡眠障碍将有助于预防中风后失眠的后期发展建议采取药物和非药物干预措施来改善失眠中风患者的HRQoL。
