Clinical course and risk factors for sleep disturbance in patients with ischemic stroke
Background Studies on insomnia in patients with ischemic stroke, particularly in the acute phase, are limited. The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to...
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| description | Background Studies on insomnia in patients with ischemic stroke, particularly in the acute phase, are limited. The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to investigate the risk factors for sleep disturbance and the clinical course of the disease in patients with acute ischemic stroke. Methods This prospective observational study included patients diagnosed with ischemic stroke between July 1, 2020, and October 31, 2021. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for insomnia and the eight-item Athens Insomnia Scale (CAIS-8) were used to diagnose insomnia. Beck Depression Inventory (BDI) was applied to evaluate the mood of patients. Patient reported their sleeping conditions, before stroke onset and during the acute (within 7 days) and chronic (3 months after presentation) stroke periods. Results In total, 195 patients with ischemic stroke were included in this study. Of these, 34.3% (67), 37.4% (73), and 29.7% (58) presented with sleep disturbance before stroke onset and during the acute and chronic stroke periods, respectively. Of the 128 patients without insomnia before stroke onset, 15.6% (20/128) presented with insomnia symptoms 3 months after stroke onset. Moreover, 13 (12.7%) of the 102 patients without sleep disturbance during the acute stroke period developed insomnia 3 months after stroke onset. Of the 67 patients with insomnia before stroke onset 29 (43.3%) did not develop the condition 3 months after stroke onset. A higher risk of sleep disturbance was associated with atrial fibrillation, hypertension, and mood disturbance in the acute stroke period, and a higher risk of insomnia was associated with low education and mood disturbance in the chronic stroke period. Conclusion The prevalence rates of sleep disturbance before and during the acute and chronic stroke periods were 34.3%, 37.4%, and 29.7%, respectively. The incidence of stroke-related insomnia was 15.6%. Patients with insomnia before stroke may recover after the stroke. Atrial fibrillation, hypertension, and mood disturbance were associated with a higher risk of sleep disturbance in the acute stroke period, whereas low education and mood disturbance were associated with insomnia in the chronic stroke period. |
| doi_str_mv | 10.1371/journal.pone.0277309 |
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The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to investigate the risk factors for sleep disturbance and the clinical course of the disease in patients with acute ischemic stroke. Methods This prospective observational study included patients diagnosed with ischemic stroke between July 1, 2020, and October 31, 2021. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for insomnia and the eight-item Athens Insomnia Scale (CAIS-8) were used to diagnose insomnia. Beck Depression Inventory (BDI) was applied to evaluate the mood of patients. Patient reported their sleeping conditions, before stroke onset and during the acute (within 7 days) and chronic (3 months after presentation) stroke periods. Results In total, 195 patients with ischemic stroke were included in this study. Of these, 34.3% (67), 37.4% (73), and 29.7% (58) presented with sleep disturbance before stroke onset and during the acute and chronic stroke periods, respectively. Of the 128 patients without insomnia before stroke onset, 15.6% (20/128) presented with insomnia symptoms 3 months after stroke onset. Moreover, 13 (12.7%) of the 102 patients without sleep disturbance during the acute stroke period developed insomnia 3 months after stroke onset. Of the 67 patients with insomnia before stroke onset 29 (43.3%) did not develop the condition 3 months after stroke onset. A higher risk of sleep disturbance was associated with atrial fibrillation, hypertension, and mood disturbance in the acute stroke period, and a higher risk of insomnia was associated with low education and mood disturbance in the chronic stroke period. Conclusion The prevalence rates of sleep disturbance before and during the acute and chronic stroke periods were 34.3%, 37.4%, and 29.7%, respectively. The incidence of stroke-related insomnia was 15.6%. Patients with insomnia before stroke may recover after the stroke. Atrial fibrillation, hypertension, and mood disturbance were associated with a higher risk of sleep disturbance in the acute stroke period, whereas low education and mood disturbance were associated with insomnia in the chronic stroke period.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0277309</identifier><identifier>PMID: 36346797</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Biology and Life Sciences ; Complications and side effects ; Disturbance ; Education ; Fibrillation ; Health risks ; Hospitals ; Hypertension ; Informed consent ; Insomnia ; Ischemia ; Magnetic resonance imaging ; Medicine and Health Sciences ; Mental depression ; Mental disorders ; Mood ; Mortality ; Patients ; Risk analysis ; Risk factors ; Self evaluation ; Signs and symptoms ; Sleep ; Sleep disorders ; Social Sciences ; Stroke ; Stroke (Disease)</subject><ispartof>PloS one, 2022-11, Vol.17 (11), p.e0277309-e0277309</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Tsai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Tsai et al 2022 Tsai et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c482t-d0484e43a0294c6d872e04db5a856067b5198c54f9d40c5541016184d9c073353</cites><orcidid>0000-0003-1814-4371</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9642877/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9642877/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Liguori, Claudio</contributor><creatorcontrib>Tsai, Hui-Ju</creatorcontrib><creatorcontrib>Wong, Yi-Sin</creatorcontrib><creatorcontrib>Ong, Cheung-Ter</creatorcontrib><title>Clinical course and risk factors for sleep disturbance in patients with ischemic stroke</title><title>PloS one</title><description>Background Studies on insomnia in patients with ischemic stroke, particularly in the acute phase, are limited. The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to investigate the risk factors for sleep disturbance and the clinical course of the disease in patients with acute ischemic stroke. Methods This prospective observational study included patients diagnosed with ischemic stroke between July 1, 2020, and October 31, 2021. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for insomnia and the eight-item Athens Insomnia Scale (CAIS-8) were used to diagnose insomnia. Beck Depression Inventory (BDI) was applied to evaluate the mood of patients. Patient reported their sleeping conditions, before stroke onset and during the acute (within 7 days) and chronic (3 months after presentation) stroke periods. Results In total, 195 patients with ischemic stroke were included in this study. Of these, 34.3% (67), 37.4% (73), and 29.7% (58) presented with sleep disturbance before stroke onset and during the acute and chronic stroke periods, respectively. Of the 128 patients without insomnia before stroke onset, 15.6% (20/128) presented with insomnia symptoms 3 months after stroke onset. Moreover, 13 (12.7%) of the 102 patients without sleep disturbance during the acute stroke period developed insomnia 3 months after stroke onset. Of the 67 patients with insomnia before stroke onset 29 (43.3%) did not develop the condition 3 months after stroke onset. A higher risk of sleep disturbance was associated with atrial fibrillation, hypertension, and mood disturbance in the acute stroke period, and a higher risk of insomnia was associated with low education and mood disturbance in the chronic stroke period. Conclusion The prevalence rates of sleep disturbance before and during the acute and chronic stroke periods were 34.3%, 37.4%, and 29.7%, respectively. The incidence of stroke-related insomnia was 15.6%. Patients with insomnia before stroke may recover after the stroke. Atrial fibrillation, hypertension, and mood disturbance were associated with a higher risk of sleep disturbance in the acute stroke period, whereas low education and mood disturbance were associated with insomnia in the chronic stroke period.</description><subject>Biology and Life Sciences</subject><subject>Complications and side effects</subject><subject>Disturbance</subject><subject>Education</subject><subject>Fibrillation</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Hypertension</subject><subject>Informed consent</subject><subject>Insomnia</subject><subject>Ischemia</subject><subject>Magnetic resonance imaging</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mood</subject><subject>Mortality</subject><subject>Patients</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Self evaluation</subject><subject>Signs and symptoms</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Social Sciences</subject><subject>Stroke</subject><subject>Stroke 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course and risk factors for sleep disturbance in patients with ischemic stroke</title><author>Tsai, Hui-Ju ; Wong, Yi-Sin ; Ong, Cheung-Ter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-d0484e43a0294c6d872e04db5a856067b5198c54f9d40c5541016184d9c073353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biology and Life Sciences</topic><topic>Complications and side effects</topic><topic>Disturbance</topic><topic>Education</topic><topic>Fibrillation</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Hypertension</topic><topic>Informed consent</topic><topic>Insomnia</topic><topic>Ischemia</topic><topic>Magnetic resonance imaging</topic><topic>Medicine and Health Sciences</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mood</topic><topic>Mortality</topic><topic>Patients</topic><topic>Risk analysis</topic><topic>Risk 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Claudio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical course and risk factors for sleep disturbance in patients with ischemic stroke</atitle><jtitle>PloS one</jtitle><date>2022-11-08</date><risdate>2022</risdate><volume>17</volume><issue>11</issue><spage>e0277309</spage><epage>e0277309</epage><pages>e0277309-e0277309</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Background Studies on insomnia in patients with ischemic stroke, particularly in the acute phase, are limited. The proportion of patients with sleep disturbance during the acute stroke period who are likely to develop insomnia in subacute and chronic stages of stroke is unknown. This study aimed to investigate the risk factors for sleep disturbance and the clinical course of the disease in patients with acute ischemic stroke. Methods This prospective observational study included patients diagnosed with ischemic stroke between July 1, 2020, and October 31, 2021. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for insomnia and the eight-item Athens Insomnia Scale (CAIS-8) were used to diagnose insomnia. Beck Depression Inventory (BDI) was applied to evaluate the mood of patients. Patient reported their sleeping conditions, before stroke onset and during the acute (within 7 days) and chronic (3 months after presentation) stroke periods. Results In total, 195 patients with ischemic stroke were included in this study. Of these, 34.3% (67), 37.4% (73), and 29.7% (58) presented with sleep disturbance before stroke onset and during the acute and chronic stroke periods, respectively. Of the 128 patients without insomnia before stroke onset, 15.6% (20/128) presented with insomnia symptoms 3 months after stroke onset. Moreover, 13 (12.7%) of the 102 patients without sleep disturbance during the acute stroke period developed insomnia 3 months after stroke onset. Of the 67 patients with insomnia before stroke onset 29 (43.3%) did not develop the condition 3 months after stroke onset. A higher risk of sleep disturbance was associated with atrial fibrillation, hypertension, and mood disturbance in the acute stroke period, and a higher risk of insomnia was associated with low education and mood disturbance in the chronic stroke period. Conclusion The prevalence rates of sleep disturbance before and during the acute and chronic stroke periods were 34.3%, 37.4%, and 29.7%, respectively. The incidence of stroke-related insomnia was 15.6%. Patients with insomnia before stroke may recover after the stroke. Atrial fibrillation, hypertension, and mood disturbance were associated with a higher risk of sleep disturbance in the acute stroke period, whereas low education and mood disturbance were associated with insomnia in the chronic stroke period.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>36346797</pmid><doi>10.1371/journal.pone.0277309</doi><tpages>e0277309</tpages><orcidid>https://orcid.org/0000-0003-1814-4371</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biology and Life Sciences Complications and side effects Disturbance Education Fibrillation Health risks Hospitals Hypertension Informed consent Insomnia Ischemia Magnetic resonance imaging Medicine and Health Sciences Mental depression Mental disorders Mood Mortality Patients Risk analysis Risk factors Self evaluation Signs and symptoms Sleep Sleep disorders Social Sciences Stroke Stroke (Disease) |
| title | Clinical course and risk factors for sleep disturbance in patients with ischemic stroke |
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