TY - JOUR
T1 - Pre-morbid sleep disturbance and its association with stroke severity
T2 - results from the international INTERSTROKE study
AU - Mc Carthy, Christine E.
AU - Yusuf, Salim
AU - Judge, Conor
AU - Ferguson, John
AU - Hankey, Graeme J.
AU - Gharan, Shahram Oveis
AU - Damasceno, Albertino
AU - Iversen, Helle Klingenberg
AU - Rosengren, Annika
AU - Ogah, Okechukwu
AU - Avezum, Luísa
AU - Lopez-Jaramillo, Patricio
AU - Xavier, Denis
AU - Wang, Xingyu
AU - Rangarajan, Sumathy
AU - O'Donnell, Martin J.
N1 - Publisher Copyright:
© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2024/6
Y1 - 2024/6
N2 - 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.
AB - 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.
KW - disability evaluation
KW - sleep
KW - sleep apnea, obstructive
KW - sleep initiation and maintenance disorders
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85189508996&partnerID=8YFLogxK
U2 - 10.1111/ene.16193
DO - 10.1111/ene.16193
M3 - Artículo Científico
C2 - 38532299
AN - SCOPUS:85189508996
SN - 1351-5101
VL - 31
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 6
M1 - e16193
ER -