Pre-morbid sleep disturbance and its association with stroke severity: results from the international INTERSTROKE study.

Autor: Mc Carthy CE; HRB Clinical Research Facility, University of Galway, Galway, Ireland., Yusuf S; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada., Judge C; HRB Clinical Research Facility, University of Galway, Galway, Ireland., Ferguson J; HRB Clinical Research Facility, University of Galway, Galway, Ireland., Hankey GJ; Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia., Gharan SO; Rush Alzheimer Disease Centre, Rush University Medical Centre, Chicago, Illinois, USA., Damasceno A; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique., Iversen HK; Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Rosengren A; Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden., Ogah O; Cardiology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria., Avezum L; Neurology Department, Hospital Santa Marcelina, Sao Paulo, Brazil., Lopez-Jaramillo P; Director de Investigaciones Facultad de Medicina, Universidad de Santander, Bucaramanga-Santander, Colombia., Xavier D; Pharmacology and Clinical Research and Training, St John's Medical College and Research Institute, Bangalore, India., Wang X; Beijing Hypertension League Institute, Beijing, China., Rangarajan S; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada., O'Donnell MJ; HRB Clinical Research Facility, University of Galway, Galway, Ireland.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2024 Jun; Vol. 31 (6), pp. e16193. Date of Electronic Publication: 2024 Mar 26.
DOI: 10.1111/ene.16193
Abstrakt: Background and Purpose: Whilst sleep disturbances are associated with stroke, their association with stroke severity is less certain. In the INTERSTROKE study, the association of pre-morbid sleep disturbance with stroke severity and functional outcome following stroke was evaluated.
Methods: INTERSTROKE is an international case-control study of first acute stroke. This analysis included cases who completed a standardized questionnaire concerning nine symptoms of sleep disturbance (sleep onset latency, duration, quality, nocturnal awakening, napping duration, whether a nap was planned, snoring, snorting and breathing cessation) in the month prior to stroke (n = 2361). Two indices were derived representing sleep disturbance (range 0-9) and obstructive sleep apnoea (range 0-3) symptoms. Logistic regression was used to estimate the magnitude of association between symptoms and stroke severity defined by the modified Rankin Score.
Results: The mean age of participants was 62.9 years, and 42% were female. On multivariable analysis, there was a graded association between increasing number of sleep disturbance symptoms and initially severe stroke (2-3, odds ratio [OR] 1.44, 95% confidence interval [CI] 1.07-1.94; 4-5, OR 1.66, 95% CI 1.23-2.25; >5, OR 2.58, 95% CI 1.83-3.66). Having >5 sleep disturbance symptoms was associated with significantly increased odds of functional deterioration at 1 month (OR 1.54, 95% CI 1.01-2.34). A higher obstructive sleep apnoea score was also associated with significantly increased odds of initially severe stroke (2-3, OR 1.48; 95% CI 1.20-1.83) but not functional deterioration at 1 month (OR 1.19, 95% CI 0.93-1.52).
Conclusions: Sleep disturbance symptoms were common and associated with an increased odds of severe stroke and functional deterioration. Interventions to modify sleep disturbance may help prevent disabling stroke/improve functional outcomes and should be the subject of future research.
(© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
Externí odkaz: