Post-Stroke Insomnia Increased the Risk of Cognitive Impairments: A Hospital-Based Retrospective Cohort Study.

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY Behavioral Sleep Medicine Pub Date : 2023-11-02 Epub Date: 2023-01-05 DOI:10.1080/15402002.2023.2165491
Faizul Hasan, Muhammad Solihuddin Muhtar, Dean Wu, Hsin-Chien Lee, Yen-Chun Fan, Ting-Jhen Chen, Hsiao-Yean Chiu
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引用次数: 1

Abstract

Objectives/background: Insomnia is a common sleep complaint among patients who had a stroke and has been recognized as an independent risk factor for cognitive impairment. However, the relationship between poststroke insomnia and cognitive impairment over time is under-researched. Therefore, we examined the association between poststroke insomnia and the risk of cognitive impairment.

Participants: Stroke participants who had a stroke and were 20 years and older.

Methods: This multicenter hospital-based retrospective cohort study with a 13-year follow-up period (2004-2017). The diagnosis of stroke, insomnia, and cognitive impairment was based on the International Classification of Diseases. The study participants who experienced a stroke were divided into two cohorts: those who also had insomnia and those who did not have insomnia. A Cox proportional-hazards regression model was used.

Results: A total of 1,775 patients with a mean age of 67.6 years were included. Of these patients, 146 and 75 patients were diagnosed with insomnia and cognitive impairment during the follow-up period, respectively. The cumulative incidence of cognitive impairment in the stroke with insomnia cohort was significantly lower than that in the stroke without insomnia cohort (log-rank test, P < .001). The adjusted hazard ratio and 95% confidence interval (CI) of the stroke with insomnia cohort indicated a higher risk of cognitive impairment compared with the stroke without insomnia cohort (adjusted hazard ratio: 2.38; 95% CI: 1.41-4.03).

Conclusions: Patients who had a stroke and were diagnosed with insomnia exhibited a substantial increased risk of cognitive impairment over time.

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卒中后失眠增加认知障碍的风险:一项基于医院的回顾性队列研究。
目的/背景:失眠是中风患者常见的睡眠问题,已被公认为认知障碍的独立风险因素。然而,随着时间的推移,脑卒中后失眠与认知障碍之间的关系仍在研究中。因此,我们研究了脑卒中后失眠与认知障碍风险之间的关系。参与者:20岁及以上的中风参与者。方法:这项基于医院的多中心回顾性队列研究,随访期为13年(2004-2017)。中风、失眠和认知障碍的诊断基于国际疾病分类。经历过中风的研究参与者被分为两组:同样失眠的人和没有失眠的人。采用Cox比例风险回归模型。结果:共纳入1775名患者,平均年龄67.6岁。在这些患者中,146名和75名患者在随访期间分别被诊断为失眠和认知障碍。脑卒中伴失眠队列中认知障碍的累计发生率显著低于脑卒中不伴失眠队列(log秩检验,P<.001)。脑卒中伴失眠症队列的校正危险比和95%置信区间(CI)表明,与脑卒中不伴有失眠队列相比,认知障碍的风险更高(调整后的危险比:2.38;95%可信区间:1.41-4.03)。结论:随着时间的推移,中风并被诊断为失眠的患者出现认知障碍的风险显著增加。
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来源期刊
Behavioral Sleep Medicine
Behavioral Sleep Medicine CLINICAL NEUROLOGY-PSYCHIATRY
CiteScore
7.20
自引率
3.20%
发文量
49
审稿时长
>12 weeks
期刊介绍: Behavioral Sleep Medicine addresses behavioral dimensions of normal and abnormal sleep mechanisms and the prevention, assessment, and treatment of sleep disorders and associated behavioral and emotional problems. Standards for interventions acceptable to this journal are guided by established principles of behavior change. Intending to serve as the intellectual home for the application of behavioral/cognitive science to the study of normal and disordered sleep, the journal paints a broad stroke across the behavioral sleep medicine landscape. Its content includes scholarly investigation of such areas as normal sleep experience, insomnia, the relation of daytime functioning to sleep, parasomnias, circadian rhythm disorders, treatment adherence, pediatrics, and geriatrics. Multidisciplinary approaches are particularly welcome. The journal’ domain encompasses human basic, applied, and clinical outcome research. Behavioral Sleep Medicine also embraces methodological diversity, spanning innovative case studies, quasi-experimentation, randomized trials, epidemiology, and critical reviews.
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