Persisting Short or Long Sleep Duration Predicts Post-Stroke Depression One year After Stroke and Transient Ischemic Attack.

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-06-27 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S492838

Yang Hu, Lijun Zuo, Yuesong Pan, Hongyi Yan, Yongjun Wang, Xingquan Zhao

{"title":"Persisting Short or Long Sleep Duration Predicts Post-Stroke Depression One year After Stroke and Transient Ischemic Attack.","authors":"Yang Hu, Lijun Zuo, Yuesong Pan, Hongyi Yan, Yongjun Wang, Xingquan Zhao","doi":"10.2147/NSS.S492838","DOIUrl":null,"url":null,"abstract":"Objective: Disrupted sleep duration is associated with the risk of stroke, and abnormal sleep duration predicts depression. However, the association of changes in sleep duration with functional outcome and depression after acute ischemic stroke (AIS) or transient ischemic attack (TIA) is still unclear.Methods: All patients diagnosed with AIS or TIA in the impairment of cognition and sleep (ICONS) from the China National Stroke Registry III were included. Post-stroke depression (PSD) was defined as a value on the Patient Health Questionnaire-9 (PHQ-9) ≥5. Sleep duration was classified as normal (7-8 hours), short (<7 hours), or long (≥9 hours). According to the sleep duration, patients were divided into four groups: group A (persisting normal), group B (changed from long or short to normal), group C (changed from normal to long or short), and group D (persisting long or short). Logistic regression was performed to evaluate the effects of sleep duration changes on PSD, quality of life, and functional outcome at 1-year follow-ups.Results: A total of 1450 AIS or TIA patients at baseline with a mean age of 60.73±10.82 years were followed for 1-year. The group with persisting long or short sleep duration exhibited a significantly higher risk of PSD [OR 1.58(95% CI (1.06~2.33)] and poor quality of life [OR 1.42(95% CI 1.04~1.94)] than those in the persisting normal group at 1-year after AIS and TIA when adjusted for covariates. Patients with a decreased sleep duration of > 1 hour had more risk of moderate to severe PSD [OR 2.26(95% CI 1.13~4.53)] than the persisting normal group. Patients with newly developed abnormal sleep duration (changed from normal to long or short) had a higher risk of poor functional outcome [OR 2.82(95% CI 1.33~5.96)] than the persisting normal group.Conclusion: The alterations in sleep duration were independently associated with PSD, poor quality of life, and adverse outcomes at 1-year, suggesting that inadequate sleep quantity plays an important role in 1-year depression, quality of life, and adverse outcomes after AIS or TIA.","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"17 ","pages":"1507-1519"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213472/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature and Science of Sleep","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/NSS.S492838","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Disrupted sleep duration is associated with the risk of stroke, and abnormal sleep duration predicts depression. However, the association of changes in sleep duration with functional outcome and depression after acute ischemic stroke (AIS) or transient ischemic attack (TIA) is still unclear.

Methods: All patients diagnosed with AIS or TIA in the impairment of cognition and sleep (ICONS) from the China National Stroke Registry III were included. Post-stroke depression (PSD) was defined as a value on the Patient Health Questionnaire-9 (PHQ-9) ≥5. Sleep duration was classified as normal (7-8 hours), short (<7 hours), or long (≥9 hours). According to the sleep duration, patients were divided into four groups: group A (persisting normal), group B (changed from long or short to normal), group C (changed from normal to long or short), and group D (persisting long or short). Logistic regression was performed to evaluate the effects of sleep duration changes on PSD, quality of life, and functional outcome at 1-year follow-ups.

Results: A total of 1450 AIS or TIA patients at baseline with a mean age of 60.73±10.82 years were followed for 1-year. The group with persisting long or short sleep duration exhibited a significantly higher risk of PSD [OR 1.58(95% CI (1.06~2.33)] and poor quality of life [OR 1.42(95% CI 1.04~1.94)] than those in the persisting normal group at 1-year after AIS and TIA when adjusted for covariates. Patients with a decreased sleep duration of > 1 hour had more risk of moderate to severe PSD [OR 2.26(95% CI 1.13~4.53)] than the persisting normal group. Patients with newly developed abnormal sleep duration (changed from normal to long or short) had a higher risk of poor functional outcome [OR 2.82(95% CI 1.33~5.96)] than the persisting normal group.

Conclusion: The alterations in sleep duration were independently associated with PSD, poor quality of life, and adverse outcomes at 1-year, suggesting that inadequate sleep quantity plays an important role in 1-year depression, quality of life, and adverse outcomes after AIS or TIA.

查看原文本刊更多论文

持续较短或较长的睡眠时间预测中风和短暂性脑缺血发作后一年的抑郁。

目的：睡眠时间中断与中风风险相关，睡眠时间异常预示抑郁。然而，急性缺血性卒中（AIS）或短暂性脑缺血发作（TIA）后睡眠时间变化与功能结局和抑郁的关系尚不清楚。方法：纳入中国卒中国家登记III期中所有诊断为AIS或TIA的认知与睡眠障碍（ICONS）患者。卒中后抑郁（PSD）定义为患者健康问卷-9 （PHQ-9）值≥5。睡眠时间分为正常（7-8小时）、睡眠时间短（结果：1450例基线时AIS或TIA患者，平均年龄为60.73±10.82岁，随访1年）。经协变量调整后，持续长时间或短时间睡眠组在AIS和TIA后1年发生PSD的风险[or 1.58(95% CI 1.06~2.33)]和生活质量差[or 1.42(95% CI 1.04~1.94)]明显高于持续正常组。睡眠时间减少100 ~ 100小时的患者发生中重度PSD的风险高于持续正常组[OR 2.26(95% CI 1.13~4.53)]。新出现异常睡眠时间（由正常变为长或短）的患者发生功能不良结局的风险高于持续正常组[or 2.82(95% CI 1.33~5.96)]。结论：睡眠时间的改变与1年PSD、生活质量差和不良结局独立相关，提示睡眠不足在AIS或TIA后1年抑郁、生活质量和不良结局中起重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.