School of Epidemiology and Public Health (Jeffers, Kendzerska, Chen), University of Ottawa; Clinical Epidemiology Program (Jeffers, Kendzerska), Ottawa Hospital Research Institute; Department of Family Medicine (Pittman), University of Ottawa; Department of Medicine (Kendzerska), Ottawa Hospital Research Institute, University of Ottawa; Department of Cellular and Molecular Medicine (Corbett), University of Ottawa, Ottawa, Ont.; Departments of Physiotherapy and of Medicine, and Florey Institute of Neuroscience and Mental Health (Hayward), University of Melbourne, Melbourne, Australia
School of Epidemiology and Public Health (Jeffers, Kendzerska, Chen), University of Ottawa; Clinical Epidemiology Program (Jeffers, Kendzerska), Ottawa Hospital Research Institute; Department of Family Medicine (Pittman), University of Ottawa; Department of Medicine (Kendzerska), Ottawa Hospital Research Institute, University of Ottawa; Department of Cellular and Molecular Medicine (Corbett), University of Ottawa, Ottawa, Ont.; Departments of Physiotherapy and of Medicine, and Florey Institute of Neuroscience and Mental Health (Hayward), University of Melbourne, Melbourne, Australia.
CMAJ. 2023 Mar 14;195(10):E354-E362. doi: 10.1503/cmaj.221063.
Sleep disturbances and their potential association with stroke remains understudied at a population level. We sought to determine the prevalence of sleep disturbances among people who have effects of stroke compared with the general population.
We used data from people aged 18 years or older who responded to the sleep and chronic disease modules of the 2017-2018 cycle of the Canadian Community Health Survey (CCHS). We measured sleep disturbances by self-reports of having trouble staying awake most or all of the time; either short (< 5 h) or long (> 9 h) nightly sleep duration; having trouble going to or staying asleep most or all of the time; and never, rarely or sometimes having refreshing sleep. We used log-binomial and multinomial regression to investigate prevalence of sleep disturbances among respondents who reported effects of stroke compared with others, adjusting for confounding factors.
We included 46 404 CCHS respondents, 682 of whom reported effects of stroke. The prevalence of sleep disturbances for those with effects of stroke was higher than among others in the sample with regard to trouble staying awake (13.0% v. 6.1%; adjusted relative risk [RR] 2.16, 95% confidence interval [CI] 1.59-2.94), short or long duration sleep (28.9% v. 10.0%; adjusted RR 1.93, 95% CI 1.57-2.38), trouble going to or staying asleep, (28.1% v. 17.6%; adjusted RR 1.53, 95% CI 1.28-1.83) and lack of refreshing sleep (41.1% v. 37.1%; adjusted RR 1.30, 95% CI 1.14-1.49). The prevalence of at least 1 reported measure of sleep disturbance was 61.6% among those with effects of stroke, compared with 48.2% among others (adjusted RR 1.28, 95% CI 1.18-1.40).
Self-report of having effects of stroke was associated with increased prevalence of sleep disturbances compared with the general population. Sleep disturbances were reported by a high proportion of respondents with effects of stroke, indicating the importance of screening for related disorders.
睡眠障碍及其与中风的潜在关联在人群层面的研究仍不够充分。我们旨在确定与一般人群相比，患有中风的人群中睡眠障碍的患病率。
我们使用了 2017-2018 年加拿大社区健康调查（CCHS）睡眠和慢性病模块中年龄在 18 岁及以上的人群的数据。我们通过自我报告的方式来衡量睡眠障碍，包括大多数或所有时间都难以保持清醒；每晚睡眠时间过短（<5 小时）或过长（>9 小时）；大多数或所有时间入睡或保持睡眠困难；以及很少或从不感到睡眠恢复。我们使用对数二项式和多项逻辑回归来调查报告有中风影响的受访者中睡眠障碍的患病率，并针对混杂因素进行了调整。
我们纳入了 46404 名 CCHS 受访者，其中 682 名报告了中风影响。与样本中的其他人相比，有中风影响的受访者的睡眠障碍患病率更高，具体表现为难以保持清醒（13.0%比 6.1%；调整后的相对风险 [RR] 2.16，95%置信区间 [CI] 1.59-2.94）、短或长睡眠时间（28.9%比 10.0%；调整后的 RR 1.93，95% CI 1.57-2.38）、入睡或保持睡眠困难（28.1%比 17.6%；调整后的 RR 1.53，95% CI 1.28-1.83）和缺乏恢复性睡眠（41.1%比 37.1%；调整后的 RR 1.30，95% CI 1.14-1.49）。有中风影响的受访者中至少有一种睡眠障碍报告的患病率为 61.6%，而其他人的这一比例为 48.2%（调整后的 RR 1.28，95% CI 1.18-1.40）。
与一般人群相比，自我报告有中风影响与睡眠障碍患病率的增加有关。有中风影响的受访者中报告睡眠障碍的比例较高，表明筛查相关疾病的重要性。
