Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China.
College of Nursing and Midwifery, Charles Darwin University, Brisbane 4000, Australia.
Int J Environ Res Public Health. 2023 Jan 29;20(3):2410. doi: 10.3390/ijerph20032410.
This study examined the association between post-stroke cognitive function and sleep status at 30 days post-stroke and evaluated the role of anxiety and depression as potential mediators of that association. The participants in this study were 530 acute ischemic stroke (IS) patients. Sleep disturbance at 30 days post-stroke was assessed by the Pittsburgh Sleep Quality Index. Basic patient information, cognitive function, depression, and anxiety status were assessed before discharge from the hospital. Stratified linear regression analysis models were fit to examine the associations between post-stroke sleep quality and the influencing factors. A structural equation model was developed to evaluate the role of anxiety and depression as potential mediators of sleep quality and cognitive function. At 30 days post-stroke, 58.7% of IS patients had sleep disturbance. Women and older IS patients were more likely to suffer poorer sleep quality ( < 0.05). A stratified linear regression analysis showed that the inclusion of cognitive function variables and indicators of depression and anxiety were statistically significant in predicting improvement in the sleep disturbance of AIS patients. Cognitive function, depression, anxiety, and sleep status were selected to construct a structural equation model. The total effect of cognitive function on sleep status was -0.274, with a direct effect of -0.097 and an indirect effect (through depression) of -0.177. The total effect of anxiety on sleep status was 0.235, with a direct effect of 0.186 and an indirect effect (through depression) of 0.049. IS patients often experience poor sleep quality. Depression in IS patients mediates two pathways: the pathway through which cognitive function affects sleep quality and the pathway through which anxiety affects sleep quality.
本研究旨在探讨脑卒中后 30 天认知功能与睡眠状况的关系，并评估焦虑和抑郁在其中的潜在中介作用。研究对象为 530 例急性缺血性脑卒中（IS）患者。采用匹兹堡睡眠质量指数评估脑卒中后 30 天的睡眠障碍。在出院前评估患者的基本信息、认知功能、抑郁和焦虑状况。采用分层线性回归分析模型来探讨脑卒中后睡眠质量与影响因素之间的关系。采用结构方程模型来评估焦虑和抑郁作为睡眠质量和认知功能潜在中介的作用。在脑卒中后 30 天，58.7%的 IS 患者存在睡眠障碍。女性和年龄较大的 IS 患者更可能出现睡眠质量较差（<0.05）。分层线性回归分析表明，纳入认知功能变量以及抑郁和焦虑指标对预测 AIS 患者睡眠障碍的改善具有统计学意义。选择认知功能、抑郁、焦虑和睡眠状况来构建结构方程模型。认知功能对睡眠状况的总效应为-0.274，直接效应为-0.097，间接效应（通过抑郁）为-0.177。焦虑对睡眠状况的总效应为 0.235，直接效应为 0.186，间接效应（通过抑郁）为 0.049。IS 患者常出现睡眠质量差的情况。抑郁在 IS 患者中存在两条中介途径：一条是通过认知功能影响睡眠质量的途径，另一条是通过焦虑影响睡眠质量的途径。
