Faculty of Health Sciences, Universidade da Beira Interior, Covilhã, Portugal; Neurology Department, Centro Hospitalar Trás-os-Montes E Alto Douro, Vila Real, Portugal.
Department of Mathematics, Universidade da Beira Interior, Covilhã, Portugal.
Sleep Med. 2022 Jun;94:1-7. doi: 10.1016/j.sleep.2022.03.022. Epub 2022 Apr 2.
Our study examined the association between insomnia, and cognitive as well as functional outcomes in a cohort of ischemic stroke patients. We evaluated which stroke features were associated with the development of post-stroke insomnia and how it might affect stroke prognosis.
157 ischemic stroke patients were retrospectively evaluated during their hospitalization in a Portuguese Stroke Unit and re-assessed two years afterwards, at a follow up appointment. We collected data including clinical variables, vascular risk factors, insomnia developed after stroke, use of psychotropic drugs, further sleep studies, specific measures of cognitive function, severity of stroke, and functional performance.
Mean age of study participants was 69.54 ± 12.71 years and 48.4% were male. Post stroke insomnia was diagnosed in 45/157 (28.6%) of patients. Compared to those subjects with no evidence of insomnia, insomnia was associated with worse neurological severity, lower functional independence and higher disability scores at admission and follow up. Male gender (p = 0.006) and previous minor vascular events (p = 0.013) were significantly associated with the development of insomnia after ischemic stroke. There were no significant differences between development of insomnia in patients suffering from anterior circulation stroke when compared with those of the posterior circulation.
Insomnia may have a negative influence on neurological recovery from ischemic stroke, and it seems to associate with worse functional and cognitive outcome of these patients. Screening and appropriate management of post-stroke insomnia should become part of the therapeutic strategy to optimize outcomes of this potentially devastating disease.
本研究调查了失眠与缺血性脑卒中患者认知和功能结局之间的关联。我们评估了哪些卒中特征与卒中后失眠的发展有关，以及它如何影响卒中预后。
我们对 157 例在葡萄牙卒中单元住院的缺血性卒中患者进行回顾性评估，并在两年后的随访预约中进行再次评估。我们收集的数据包括临床变量、血管危险因素、卒中后发生的失眠、使用精神药物、进一步的睡眠研究、认知功能的特定测量、卒中严重程度和功能表现。
研究参与者的平均年龄为 69.54±12.71 岁，48.4%为男性。在 157 例患者中，诊断出卒中后失眠 45 例（28.6%）。与无失眠证据的患者相比，失眠与入院和随访时神经功能严重程度较差、功能独立性较低和残疾评分较高有关。男性（p=0.006）和既往小血管事件（p=0.013）与缺血性卒中后失眠的发生显著相关。在前循环卒中患者和后循环卒中患者中，失眠的发生无显著差异。
失眠可能对缺血性卒中的神经恢复产生负面影响，并且似乎与这些患者的功能和认知结局较差有关。对卒中后失眠的筛查和适当管理应成为优化这种潜在破坏性疾病治疗效果的治疗策略的一部分。
