Clinical and radiologic correlates of insomnia symptoms in ischemic stroke patients

• Published in: International journal of geriatric psychiatry Vol. 26; no. 5; pp. 451 - 457
• Main Authors: Chen, Yang-Kun, Lu, Jin-Yan, Mok, Vincent CT, Ungvari, GS, Chu, Winnie CW, Wong, Ka Sing, Tang, Wai Kwong
• Format: Journal Article
• Language: English
• Published: Hove Blackwell Publishing Ltd 01.05.2011; Psychology Press; Wiley Subscription Services, Inc
• Subjects: Aged; Biological and medical sciences; Brain Ischemia - complications; Brain Ischemia - pathology; Cerebral infarction; Daytime; Depression; Depressive Disorder - complications; Diabetes mellitus; Female; Frontal Lobe; Fundamental and applied biological sciences. Psychology; General aspects; Geriatric Assessment; Geriatric psychiatry; Geriatric psychology; Geriatrics; Hong Kong; Humans; infarction; Insomnia; Inventories; Ischemia; Magnetic Resonance Imaging; Male; Medical sciences; Mental depression; Middle Aged; Multivariate Analysis; NMR; Nuclear magnetic resonance; Psychoanalysis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression analysis; Risk Factors; Sleep disorders; Sleep Initiation and Maintenance Disorders - etiology; Sleep Initiation and Maintenance Disorders - pathology; Sleep Initiation and Maintenance Disorders - psychology; Stroke; Stroke - complications; Stroke - pathology; Substantia alba; Surveys and Questionnaires; Survivor; Hong Kong; Mood disorder; Human; Cerebral infarction; Nervous system diseases; Stroke; Frontal lobe; Infarct; Sleep disorder; infarction; Cardiovascular disease; Depression; Patient; Cerebral disorder; Vascular disease; Symptomatology; Gerontology; Insomnia; Central nervous system disease; Brain ischemia; Neurological disorder; Elderly; Psychiatry; Cerebrovascular disease; Geriatrics
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.2547

ObjectivesInsomnia is a common complaint in stroke survivors. The purpose of this study was to investigate the clinical and magnetic resonance imaging (MRI) correlates of insomnia symptoms in Chinese ischemic stroke survivors. MethodsA comprehensive psychiatric assessment was performed involving 508 ischemic stroke patients 3 months after their first‐ever or recurrent acute stroke. Insomnia symptoms were evaluated with a standard insomnia questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS).The evaluation of the MRI scans focused on infarctions, white matter lesions, and microbleeds. ResultsOne hundred and eight‐six patients (36.6% of the sample) had insomnia symptoms. Sixty‐four patients (12.6%) had insomnia symptoms with daytime consequences. In the multivariate logistic regression analysis, GDS score (OR = 1.157, p < 0.001) and acute frontal lobe infarction (OR = 1.933, p = 0.039) were significant predictors of insomnia symptoms, while the GDS score (OR = 1.251, p < 0.001) and diabetes mellitus (OR = 1.959, p = 0.017) were significant predictors of insomnia symptoms with daytime consequences. ConclusionsInsomnia symptoms have a multi‐factorial origin in stroke. Besides depressive symptoms, frontal lobe infarction and diabetes mellitus predict insomnia symptoms. Copyright © 2010 John Wiley & Sons, Ltd.