Liming Dong1, Devin L Brown2, Ronald D Chervin3, Erin Case4, Lewis B Morgenstern5, Lynda D Lisabeth5. 1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. Electronic address: lmdong@umich.edu. 2. Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA. 3. Sleep Disorders Center, University of Michigan Medical School, Ann Arbor, MI, USA. 4. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. 5. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA.
Abstract
OBJECTIVE: Sleep disturbance and depression are common in stroke patients, however, little is known about the role of sleep in post-stroke depression. This study examined the association between pre-stroke sleep duration and depression at 90 days post-stroke in a population-based bi-ethnic sample. METHODS: The study included 1369 stroke patients from the Brain Attack Surveillance in Corpus Christi project who survived 90 days post-stroke. Depression at 90 days post-stroke was assessed by the 8-item Patient Health Questionnaire, and pre-stroke sleep duration was self-reported shortly after stroke in reference to the pre-stroke state. Multiple imputation and inverse probability weighting were used to deal with missing data and attrition. Weighted logistic regression models were fit to examine the association between pre-stroke sleep duration and post-stroke depression. RESULTS: The mean age was 68.2 years, and 63.6% were Mexican American. The prevalence of post-stroke depression was highest among participants reporting less than 6 hours of sleep before stroke (52.4%, 95% confidence interval = 45.7%-59.0%). Compared with participants reporting 7-8 hours of sleep before stroke, those with short sleep duration had significantly increased odds for post-stroke depression (odds ratio = 1.96; 95% confidence interval = 1.38-2.79), after adjustment for sociodemographic, stroke and pre-stroke characteristics including pre-stroke depression. CONCLUSIONS: Pre-stroke short sleep duration may be an independent risk factor for post-stroke depression.
OBJECTIVE: Sleep disturbance and depression are common in stroke patients, however, little is known about the role of sleep in post-stroke depression. This study examined the association between pre-stroke sleep duration and depression at 90 days post-stroke in a population-based bi-ethnic sample. METHODS: The study included 1369 stroke patients from the Brain Attack Surveillance in Corpus Christi project who survived 90 days post-stroke. Depression at 90 days post-stroke was assessed by the 8-item Patient Health Questionnaire, and pre-stroke sleep duration was self-reported shortly after stroke in reference to the pre-stroke state. Multiple imputation and inverse probability weighting were used to deal with missing data and attrition. Weighted logistic regression models were fit to examine the association between pre-stroke sleep duration and post-stroke depression. RESULTS: The mean age was 68.2 years, and 63.6% were Mexican American. The prevalence of post-stroke depression was highest among participants reporting less than 6 hours of sleep before stroke (52.4%, 95% confidence interval = 45.7%-59.0%). Compared with participants reporting 7-8 hours of sleep before stroke, those with short sleep duration had significantly increased odds for post-stroke depression (odds ratio = 1.96; 95% confidence interval = 1.38-2.79), after adjustment for sociodemographic, stroke and pre-stroke characteristics including pre-stroke depression. CONCLUSIONS: Pre-stroke short sleep duration may be an independent risk factor for post-stroke depression.
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