Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA; Stroke Program - Cardiovascular Center, Department of Neurology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Sleep Med. 2022 Dec;100:219-224. doi: 10.1016/j.sleep.2022.08.017. Epub 2022 Sep 3.
OBJECTIVE/BACKGROUND: To examine the association between ethnicity and 90-day post-stroke subjective sleepiness, an important determinant of quality of life, as measured by the Epworth Sleepiness Scale (ESS), among ischemic stroke survivors.
PATIENTS/METHODS: Mexican American (MA) and non-Hispanic white (NHW) recent ischemic stroke patients were identified from the population-based Brain Attack Surveillance in Corpus Christi Project (2010-2016). Subjects completed a baseline interview and 90-day outcome assessment that included the ESS. Excessive daytime sleepiness was defined as an ESS >10. Tobit regression models were used to assess associations between ethnicity and ESS unadjusted and adjusted for multiple potential confounders.
Among 1,181 (62.5% MA) subjects, mean ESS at 90 days was 8.9 (SD 6.0) among MA and 7.4 (SD 4.9) among NHW subjects: 1.45 (95% CI: 0.75, 2.15) points higher among MA than NHW subjects. After adjustment, mean ESS at 90 days was 1.16 (95% CI: 0.38, 1.94) points higher among MAs than NHWs. The prevalence of excessive daytime sleepiness was 39% among MA and 30% among NHW subjects (p = 0.0013).
Ninety days after stroke, sleepiness is worse in MAs compared to NHWs, even after accounting for potential confounding variables. Further studies should address ways to reduce this disparity.
目的/背景：通过埃普沃思嗜睡量表（ESS）评估缺血性卒中幸存者 90 天后的主观嗜睡情况，这种嗜睡是生活质量的一个重要决定因素，来研究种族与主观嗜睡之间的关系。
患者/方法：从基于人群的科珀斯克里斯蒂脑卒中专案（2010-2016 年）中确定了墨西哥裔美国（MA）和非西班牙裔白人（NHW）近期缺血性脑卒中患者。受试者完成了基线访谈和 90 天的结果评估，其中包括 ESS。白天过度嗜睡被定义为 ESS>10。使用 Tobit 回归模型评估了在未调整和调整了多个潜在混杂因素后，种族与 ESS 之间的关联。
在 1181 名受试者中（62.5%为 MA），MA 组 90 天时的 ESS 均值为 8.9（SD 6.0），NHW 组为 7.4（SD 4.9）：MA 组比 NHW 组高 1.45（95%CI：0.75，2.15）分。调整后，MA 组 90 天时的 ESS 均值比 NHW 组高 1.16（95%CI：0.38，1.94）分。MA 组中白天过度嗜睡的患病率为 39%，NHW 组为 30%（p=0.0013）。
与 NHW 相比，90 天后 MA 的卒中后嗜睡更严重，即使考虑到潜在的混杂变量也是如此。应进一步研究如何减少这种差异。
