Impact of Sleep Duration on Depression and Anxiety After Acute Ischemic Stroke.

Abnormal sleep duration predicts depression and anxiety. We seek to evaluate the impact of sleep duration before stroke on the occurrence of depression and anxiety at 3 months after acute ischemic stroke (AIS). Nationally representative samples from the Third China National Stroke Registry were used to examine cognition and sleep impairment after AIS (CNSR-III-ICONS). Based on baseline sleep duration before onset of stroke as measured by using the Pittsburgh Sleep Quality Index (PSQI), 1,446 patients were divided into four groups: >7, 6-7, 5-6, and <5 h of sleep. Patients were followed up with the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) for 3 months. Poststroke anxiety (PSA) was defined as GAD-7 of ≥5 and poststroke depression (PSD) as PHQ-9 of ≥5. The association of sleep duration with PSA and PSD was evaluated using multivariable logistic regression. The incidences of PSA and PSD were 11.2 and 17.6% at 3 months, respectively. Compared to a sleep duration of >7 h, 5-6 h, and <5 h of sleep were identified as risk factors of PSA [odds ratio (OR), 1.95; 95% confidence interval (CI), 1.24-3.07; < 0.01 and OR, 3.41; 95% CI, 1.94-6.04; < 0.01) and PSD (OR, 1.47; 95% CI, 1.00-2.17; = 0.04 and OR, 3.05; 95% CI, 1.85-5.02; < 0.01), while 6-7 h of sleep was associated with neither PSA (OR, 1.09; 95% CI, 0.71-1.67; = 0.68) nor PSD (OR, 0.92; 95% CI, 0.64-1.30; = 0.64). In interaction analysis, the impact of sleep duration on PSA and PSD was not affected by gender ( = 0.68 and = 0.29, respectively). Sleep duration of shorter than 6 h was predictive of anxiety and depression after ischemic stroke.