The prevalence and clinical significance of sleep disorders in acute ischemic stroke patients—a questionnaire study

• Published in: Sleep & breathing Vol. 21; no. 3; pp. 759 - 765
• Main Authors: Kim, Keun Tae, Moon, Hye-Jin, Yang, Jun-Gyu, Sohn, Sung-II, Hong, Jeong-Ho, Cho, Yong Won
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2017; Springer Nature B.V
• Subjects: Anxiety; Apnea; Clinical significance; Clinical trials; Dentistry; Epidemiology • Original Article; Internal Medicine; Ischemia; Medicine; Medicine & Public Health; Mental depression; Neurology; Otorhinolaryngology; Patients; Pediatrics; Pneumology/Respiratory System; Questionnaires; Sleep and wakefulness; Sleep disorders; Stroke; Sleep disorder; Stroke; Prognosis; Comorbidity
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-016-1454-5

Purpose Sleep disturbances are frequently reported in stroke patients and associated with the outcome of strokes. Using sleep questionnaires, we investigated the prevalence of classified sleep disturbance and the influence of sleep disorders upon a stroke prognosis. Methods Patients with acute ischemic strokes or transient ischemic attacks (TIA) were included. We investigated the prevalence of sleep disturbance and the association of outcomes resulting from strokes. The National Institutes of Health Stroke Scale score at day 7 (NIHSS-7) and modified Rankin Scale score at month 3 (mRS-3) stood for short- and long-term outcomes. A series of questionnaires including all Korean versions of the Pittsburgh Sleep Quality Index (PSQI-K), Insomnia Severity Index (ISI-K), Epworth Sleepiness Scale (ESS-K), Berlin Questionnaire, Sleep Obstructive apnea score optimized for Stroke (SOS), Beck Depression Inventory-2, and Hospital Anxiety and Depression Scale were used. Results A total of 241 (mean age was 64.2 ± 11.9, 146 males; 60.6%) consecutive acute ischemic stroke patients, including 36 TIAs, were enrolled. The NIHSS score at admission, NIHSS-7, and mRS-3 were 3.26 ± 3.64, 1.72 ± 2.29, and 0.21 ± 0.82, respectively. PSQI-K ≥8.5 was reported in 79 subjects (32.8%), ISI-K ≥15.5 in 29 (12.0%), ESS-K ≥11 in 21 (8.7%), and SOS ≥11 in 48 (20.3%). The NIHSS-7 was associated with the SOS (standardized β  = 0.281, p  < 0.001) and the mRS-3 with the ISI-K (standardized β  = 0.219, p  = 0.001) and the SOS (standardized β  = 0.171, p  = 0.011). Conclusions Screening for and intervening in the sleep problems of stroke patients could improve their outcome. As sleep disturbances are associated with short-term and/or long-term outcomes of strokes, active screening and intervention for sleep disturbances after strokes are needed.