Incidence and prevalence of post-stroke insomnia: A systematic review and meta-analysis

Baylan, Satu; Griffiths, S; Grant, Nicola; Broomfield, Niall M.; Evans, Jonathan J.; Gardani, Maria

doi:10.1016/j.smrv.2019.101222

Cited by 113 publications

(99 citation statements)

References 64 publications

(46 reference statements)

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“…Long sleep duration is associated with cerebrovascular disease 43,44 which is a contributor to cognitive impairment and cognitive decline 45,46 . Persons with cardiovascular disease have more often problems in maintaining sleep 47,48 . When hours awake in bed are not explicitly excluded, those persons might tend to recall longer sleep durations without subtracting time awake in bed.…”

Section: Discussionmentioning

confidence: 99%

Associations between self-reported sleep characteristics and incident mild cognitive impairment: The Heinz Nixdorf Recall Cohort Study

Brachem

Winkler

Tebrügge

et al. 2020

Sci Rep

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Associations of sleep characteristics with mild cognitive impairment (Mci) have been examined in cross-sectional, but rarely in longitudinal studies. incident Mci and sleep characteristics were assessed in 1,890 participants of the first and second follow-up of the Heinz Nixdorf Recall study, a populationbased cohort study in Germany (age at first follow-up 50−80 years, mean follow-up 5.2 years). MCI was assessed with extensive cognitive tests. Sleep questionnaires including pSQi (pittsburgh Sleep Quality index) were used to assess sleep quality, sleep disturbances, time asleep, and time in bed. Relative risks (RR) of developing Mci when exposed to sleep characteristics were assessed in regression models adjusted for sociodemographic and cardiovascular risk factors. poor sleep quality (pSQi > 5) (RR = 1.43, 95% CI: 1.12−1.82, fully adjusted, reference: PSQI ≤ 5) and difficulties initiating sleep (almost nightly versus never) (RR = 1.40, 0.94−2.08) were associated with incident MCI. For time in bed, the risk of MCI was increased for ≤ 5 hours (RR = 2.86, 1.24─6.60, reference:7 to <8 hours). In this longitudinal study with older participants, MCI risk was increased in persons with poor sleep quality, difficulties initiating sleep, and short time in bed. Dementia is a growing public health burden worldwide. In 2013 an estimated 44.35 million persons had a prevalent dementia 1. By 2050 it is expected that this number triples to 135.46 million prevalent dementia cases 2,3. Because no effective causal medical therapies are available for dementia, primary prevention of dementia and of its early precursors is the most promising option currently available to cap the rising prevalence 4,5. Subjects with mild cognitive impairment (MCI) have an increased risk of progression to Alzheimer's disease (AD) and other forms of dementia. Therefore, identification of modifiable risk factors for incident MCI is important, and poor sleep is considered a potential risk factor for cognitive decline and disease progression 6-13. Sleep characteristics were suggested as modifiable risk factors for cognitive decline, for example by influencing hippocampal volume 14,15. Two up-to-date reviews on this relationship indicate an association between cognitive decline and sleep problems, such as poor sleep quality, short or long sleep duration, and sleep disturbances 12,16. However, both reviews concluded that there is still a need for long term prospective studies to ensure that sleep problems precede cognitive decline 12,16. Two recently published cohort studies on sleep characteristics and dementia were not included in these reviews 17,18. Both suggest that self-reported long sleep duration as well as self-reported sleep disturbances increase the risk of dementia. Additionally, Jackowska and Cadar 19 found an association between decreased cognitive function and self-reported long and short sleep duration in their

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Section: Discussionmentioning

confidence: 99%

Associations between self-reported sleep characteristics and incident mild cognitive impairment: The Heinz Nixdorf Recall Cohort Study

Brachem

Winkler

Tebrügge

et al. 2020

Sci Rep

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“…A related meta-analysis shows that the incidence is as high as 38.2%. [ 4 ] Insomnia not only affects stroke recovery and quality of life, but also increases the risk of stroke recurrence and mental disorders such as anxiety and cognitive decline. [ 5 – 8 ] The pathogenesis of PSI is complex, and the research is insufficient.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture for post-stroke insomnia

Xiang

Li²,

Xiong

et al. 2020

Medicine

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Background: Post-stroke insomnia (PSI) is a significant complication of stroke, which often affects patients in various aspects. Acupuncture has fewer side effect and is increasingly used to treat PSI. The purpose of this study is to summarize the efficacy and safety of acupuncture for PSI. Methods: We will perform a comprehensive electronic searching, including PubMed, Embase, Cochrane Library, WangFang Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, from inception to July 2020. We will also manually retrieve references, and contact lead authors. Randomized clinical trials (RCTs) of acupuncture for PSI will be included, regardless of whether blind method and allocation concealment are used. The outcomes of interest include: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), efficacy standards of Chinese medicine, relapse rate after follow-up, adverse events, quality of life. To assess the risk of bias, we will use the Cochrane risk assessment tool. RevMan 5.3 software will be used to conduct data synthesis. The evidence quality of each outcome will be appraised according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). Results: The results will be published in a peer-reviewed journal. Conclusion: This study will provide a high-quality evidence to evaluate the efficacy and adverse reactions of acupuncture for PSI. PROSPERO registration number: CRD42020157865.

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“…Under recognition of SDB lead to high functional impairment in the long term. Furthermore, in a systematic review about insomnia after stroke, it was found that insomnia prevalence ranges from 14 % to 59 % in studies used clinical diagnostic tools and 19.8% to 69% using non-clinical diagnostic tools and a variety of diagnostic questionnaires, and in that systematic review, one study reported association between cortical lesions and poor sleep quality [26], in our cross-sectional study insomnia prevalence was 14.7 % with 10.7 % had initial insomnia. Insomnia stands as independent risk factor for cerebrovascular reactivity (CVR) and aggravation of sympathetic hyperactivity [27], thus early detection and management is mandatory.…”

Section: Discussionmentioning

confidence: 99%

Post-stroke sleep disorders in Egyptian patients by using simply administered questionnaires: a study from Ain Shams University

Mansour

Ayad²,

Sadek

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Introduction: Stroke is a leading cause of disability worldwide with grave morbidity and mortality. Sleep and stroke have a definite intermingling neuropathological relationship, so along with expeditious acute management, efficient secondary prevention and consistent rehabilitation, sleep disorders' management has a hand in offering a medical service up to the mark. Objective: Screening of sleep disorders' prevalence in patients who survived a previous stroke by applying simple questionnaires and to determine the correlation between these disorders and stroke's demographic, clinical, and risk factor variables. Methods: Cross-sectional prospective study on 75 stroke patients from stroke outpatient clinic and all patients were subjected to answer a sheet of sleep questionnaire, Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Apnea/Hypopnea Index (AHI), Arabic versions. Results A total of 70.6 % were found to have sleep disorders, 61.6% had poor sleep quality, 20% had a severe degree of excessive day time sleepiness (EDS). Sleep disorders were more prevalent in the moderate severity of stroke by NIHSS and in the first 1-4 weeks. There was no correlation between the occurrence of sleep disorders and the site of the lesion. Conclusion: Sleep disorders are broadly prevalent after a stroke. Resulting damage impedes the functional outcome. Simple questionnaires are easy applicable methods for screening of such disorders in post-stroke patients. Guidelines needed regarding screening and management of sleep disorders after a stroke.

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Incidence and prevalence of post-stroke insomnia: A systematic review and meta-analysis

Cited by 113 publications

References 64 publications

Associations between self-reported sleep characteristics and incident mild cognitive impairment: The Heinz Nixdorf Recall Cohort Study

Associations between self-reported sleep characteristics and incident mild cognitive impairment: The Heinz Nixdorf Recall Cohort Study

Acupuncture for post-stroke insomnia

Post-stroke sleep disorders in Egyptian patients by using simply administered questionnaires: a study from Ain Shams University

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