Fan Xiao-Wei, Yang Yang, Wang Shuo, Zhang Yi-Jun, Wang An-Xin, Liao Xiao-Ling, Ma Wei-Guo, Zhang Ning, Wang Chun-Xue, Wang Yong-Jun
Department of Neurology, Capital Medical University, Beijing, People's Republic of China.
Center of Stroke, Beijing Institute for Brain Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Nat Sci Sleep. 2022 Jun 13;14:1125-1135. doi: 10.2147/NSS.S357536. eCollection 2022.
The impact of poor sleep quality after stroke, especially persistent poor sleep quality, on poststroke anxiety and depression is unclear. We seek to investigate the impact of baseline and persistent poor sleep quality on short-term poststroke anxiety and depression.
Data were analyzed for 1619 patients with acute ischemic stroke from the Impairment of Cognition and Sleep after Acute Ischemic Stroke or Transient Ischemic Attack in Chinese Patients study (ICONS). The sleep quality was assessed at 2 weeks and 3 months using the Pittsburgh Sleep Quality Index scale (PSQI). Poor sleep quality was defined as a PSQI score of >5, and persistent poor sleep quality was defined as a PSQI score of >5 at each time point. Patients were divided into three groups according to the quality of sleep: good sleep quality, baseline poor sleep quality and persistent poor sleep quality. Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 scale (GAD-7), and Modified Rankin Scale (mRS) at 3 months after stroke were taken as the study outcomes.
Persistent poor sleep quality was present in 70.2% of patients after stroke. Compared to those with good sleep quality, patients with baseline poor sleep quality did not show significant differences in disability, anxiety and depression. However, patients with persistent poor sleep were at increased risk of depression (odds ratio, OR 3.04, 95% confidence interval, CI 1.66-5.57, P < 0.01) and anxiety (OR 3.20, 95% CI 1.42-7.19, P < 0.01) at 3 months after stroke. Persistent poor sleep quality was not identified as a risk factor for functional disability at 3 months.
Patients with persistent poor sleep quality are at added risks for depression and anxiety after stroke.
卒中后睡眠质量差，尤其是持续性睡眠质量差，对卒中后焦虑和抑郁的影响尚不清楚。我们旨在研究基线及持续性睡眠质量差对卒中后短期焦虑和抑郁的影响。
对来自中国急性缺血性卒中或短暂性脑缺血发作后认知与睡眠障碍研究（ICONS）的1619例急性缺血性卒中患者的数据进行分析。使用匹兹堡睡眠质量指数量表（PSQI）在2周和3个月时评估睡眠质量。睡眠质量差定义为PSQI评分>5分，持续性睡眠质量差定义为各时间点PSQI评分均>5分。根据睡眠质量将患者分为三组：睡眠质量好、基线睡眠质量差和持续性睡眠质量差。将卒中后3个月时的患者健康问卷-9（PHQ-9）、广泛性焦虑障碍-7量表（GAD-7）和改良Rankin量表（mRS）作为研究结局。
卒中后70.2%的患者存在持续性睡眠质量差。与睡眠质量好的患者相比，基线睡眠质量差的患者在残疾、焦虑和抑郁方面未显示出显著差异。然而，持续性睡眠质量差的患者在卒中后3个月时发生抑郁（优势比，OR 3.04，95%置信区间，CI 1.66-5.57，P<0.01）和焦虑（OR 3.20，95%CI 1.42-7.19，P<0.01）的风险增加。持续性睡眠质量差未被确定为卒中后3个月时功能残疾的危险因素。
持续性睡眠质量差的患者卒中后发生抑郁和焦虑的风险增加。
