Ihle-Hansen Håkon, Hagberg Guri, Ihle-Hansen Hege, Munthe-Kaas Ragnhild, Aam Stina, Aamodt Eva B, Lydersen Stian, Beyer Mona K, Luzum Geske, Saltvedt Ingvild, Askim Torunn
Department of Medicine Bærum Hospital, Vestre Viken Hospital Trust Gjettum Norway.
Department of Medical Research Bærum Hospital, Vestre Viken Hospital Trust Gjettum Norway.
J Am Heart Assoc. 2025 Apr 15;14(8):e038125. doi: 10.1161/JAHA.124.038125. Epub 2025 Apr 10.
The impact of sleep duration on cognition, particularly in the context of poststroke cognitive impairment, is not fully understood. Therefore, our objective was to investigate how sleep duration after stroke predicts poststroke cognitive impairment.
Patients admitted with acute stroke between 2015 and 2017 were consecutively recruited to the Nor-COAST (Norwegian Cognitive Impairment After Stroke) study and invited to follow-up assessments at 3 and 18 months. Time in bed, used as a surrogate for sleep duration at 3 months post stroke, was measured using the activPAL thigh-worn sensor over a 3-day period. Sleep duration was categorized into 3 groups: <7 hours (insufficient), 7 to 9 hours (reference), and ≥9 hours (excessive). Cognitive impairment was assessed based on the criteria at 3- and 18-month follow-up. Out of the 815 patients, we included 443 (54%) prestroke cognitive healthy with valid activPAL registration in this analysis. Mean±SD age was 71.2±11.4 years, 185 (42%) were women, 363 (82%) had prestroke modified Rankin Scale score <2, and 345 (78%) suffered a minor stroke (National Institutes of Health Stroke Scale score ≤5). On average, participants spent 8.3±1.4 hours in bed each night, 17.2% had a sleep duration <7 hours, and 25% slept more than 9 hours. Insufficient (odds ratio [OR], 3.6 [95% CI, 1.3-10.2], and OR, 1.4 [95% CI, 0.5-3.8]) and excessive (OR, 2.8 [95% CI, 1.1-7.5], and OR, 3.3 [95% CI, 1.3-8.1]) sleep duration were associated with an increased risk of cognitive impairment at 3- and 18-month follow-up, respectively.
Insufficient or excessive sleep duration was associated with poststroke cognitive impairment.
睡眠时间对认知的影响，尤其是在中风后认知障碍的背景下，尚未完全明确。因此，我们的目的是研究中风后的睡眠时间如何预测中风后认知障碍。
2015年至2017年收治的急性中风患者被连续纳入挪威中风后认知障碍（Nor-COAST）研究，并被邀请在3个月和18个月时进行随访评估。中风后3个月时，使用activPAL大腿佩戴式传感器在3天内测量卧床时间，作为睡眠时间的替代指标。睡眠时间分为3组：<7小时（不足）、7至9小时（参照）和≥9小时（过长）。在3个月和18个月随访时，根据相关标准评估认知障碍。在815例患者中，本分析纳入了443例（54%）中风前认知功能正常且有有效activPAL记录的患者。平均年龄±标准差为71.2±11.4岁，185例（42%）为女性，363例（82%）中风前改良Rankin量表评分<2，345例（78%）发生轻度中风（美国国立卫生研究院卒中量表评分≤5）。参与者平均每晚卧床8.3±1.4小时，17.2%的睡眠时间<7小时，25%的睡眠时间超过9小时。睡眠时间不足（比值比[OR]，3.6[95%CI，1.3 - 10.2]，以及OR，1.4[95%CI，0.5 - 3.8]）和过长（OR，2.8[95%CI，1.1 - 7.5]，以及OR，3.3[95%CI，1.3 - 8.1]）分别与3个月和18个月随访时认知障碍风险增加相关。
睡眠时间不足或过长与中风后认知障碍相关。
