Insomnia in Ischemic Stroke Patients

This is the first study that focuses on insomnia in stroke patients. A subgroup of 277 patients from a consecutive series of 486 stroke patients aged 55–85 years was subjected to a comprehensive psychiatric evaluation 3–4 months after ischemic stroke. Of 277 patients, 56.7% reported any insomnia complaint and 37.5% fulfilled the DSM-IV criteria of insomnia. In 38.6%, insomnia complaint/insomnia had already been present prior to the stroke and in 18.1%, it was a consequence of the stroke. Independent correlates of any insomnia complaint/insomnia were anxiety (Zung Anxiety Scale) and the use of psychotropic drug. Independent correlates of poststroke-onset insomnia complaint/insomnia were disability after stroke (Barthel Index), dementia, anxiety and use of psychotropic drug. Insomnia should be taken into consideration in treating and rehabilitating stroke patients.

[1]  Lippincott Williams Wilkins,et al.  Multicenter Trial of Hemodilution in Ischemic Stroke — Background and Study Protocol , 1985, Stroke.

[2]  Lr Derogatis,et al.  SCL-90-R, Administration, Scoring, and Procedures Manual-II for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series , 1983 .

[3]  A. Tien,et al.  Schedules for Clinical Assessment in Neuropsychiatry (SCAN): introduction to WV's mental health community. , 1998, The West Virginia medical journal.

[4]  M. Ohayon Prevalence of DSM-IV diagnostic criteria of insomnia: distinguishing insomnia related to mental disorders from sleep disorders. , 1997, Journal of psychiatric research.

[5]  John K. Wing,et al.  Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Program , 1974 .

[6]  A. Stoudemire,et al.  Sleep disorders in the medically ill patient. , 1992, The Journal of clinical psychiatry.

[7]  M. Ohayon,et al.  Epidemiological study on insomnia in the general population. , 1996, Sleep.

[8]  M. Kaste,et al.  Comparison of stroke features and disability in daily life in patients with ischemic stroke aged 55 to 70 and 71 to 85 years. , 1997, Stroke.

[9]  C. Guilleminault,et al.  Insomnia and use of hypnotics: study of a French population. , 1991, Sleep.

[10]  G. Kennedy,et al.  Persistence and remission of depressive symptoms in late life. , 1991, The American journal of psychiatry.

[11]  D. Ford,et al.  Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? , 1989, JAMA.

[12]  M. Kaste,et al.  Clinical determinants of poststroke dementia. , 1998, Stroke.

[13]  W W Zung,et al.  A rating instrument for anxiety disorders. , 1971, Psychosomatics.

[14]  E. Schramm,et al.  Mental comorbidity of chronic insomnia in general practice attenders using DSM‐III‐R , 1995, Acta psychiatrica Scandinavica.

[15]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[16]  A. Beck,et al.  Screening depressed patients in family practice. A rapid technic. , 1972, Postgraduate medicine.

[17]  M. Kaste,et al.  Frequency and clinical determinants of poststroke depression. , 1998, Stroke.

[18]  P. Ingrand,et al.  Habitual snoring as a risk factor for brain infarction , 1995, Acta neurologica Scandinavica.

[19]  G. Livingston,et al.  Does sleep disturbance predict depression in elderly people? A study in inner London. , 1993, The British journal of general practice : the journal of the Royal College of General Practitioners.

[20]  W. Eaton,et al.  Prodromes and precursors: epidemiologic data for primary prevention of disorders with slow onset. , 1995, The American journal of psychiatry.

[21]  D. Good,et al.  Sleep-disordered breathing and poor functional outcome after stroke. , 1996, Stroke.

[22]  D. Bliwise,et al.  Sleep in normal aging and dementia. , 1993, Sleep.

[23]  P M Moodie,et al.  COHORT , 1971, The Medical journal of Australia.

[24]  E. Bixler,et al.  Prevalence of sleep disorders in the Los Angeles metropolitan area. , 1979, The American journal of psychiatry.

[25]  F. Mahoney,et al.  Functional evaluation ; the Barthel index. A simple index of the independence useful in scoring improvement in the rehabilitation of the chronically ill. , 1965 .

[26]  Post‐stroke sleep disorder treated with the selective serotonin reuptake inhibitor citalopram—a case study , 1996 .

[27]  O Salonen,et al.  Variable agreement between visual rating scales for white matter hyperintensities on MRI. Comparison of 13 rating scales in a poststroke cohort. , 1997, Stroke.

[28]  J. Rabe-Jabłońska,et al.  [Affective disorders in the fourth edition of the classification of mental disorders prepared by the American Psychiatric Association -- diagnostic and statistical manual of mental disorders]. , 1993, Psychiatria polska.

[29]  E. Uhlenhuth,et al.  Insomnia and its treatment. Prevalence and correlates. , 1985, Archives of general psychiatry.

[30]  M Jinks,et al.  Insomnia and its treatment. , 1976, Journal of the American Pharmaceutical Association.

[31]  F. Nouri,et al.  Use of the Nottingham Health Profile with patients after a stroke. , 1986, Journal of epidemiology and community health.

[32]  M. Linden,et al.  Differences in self-reported sleep complaints in elderly persons living in the community who do or do not take sleep medication. , 1998, The Journal of clinical psychiatry.

[33]  C. Guilleminault,et al.  DSM–IV and ICSD–90 insomnia symptoms and sleep dissatisfaction , 1997, British Journal of Psychiatry.

[34]  R. Priest Measurement and Classification of Psychiatric Symptoms , 1975 .

[35]  S. Weyerer,et al.  Prevalence of insomnia in elderly general practice attenders and the current treatment modalities , 1994, Acta psychiatrica Scandinavica.

[36]  W. Strawbridge,et al.  Sleep complaints and depression in an aging cohort: A prospective perspective. , 2000, The American journal of psychiatry.

[37]  D. Katz,et al.  Clinical correlates of insomnia in patients with chronic illness. , 1998, Archives of internal medicine.

[38]  M. Kaste,et al.  Dementia three months after stroke. Baseline frequency and effect of different definitions of dementia in the Helsinki Stroke Aging Memory Study (SAM) cohort. , 1997, Stroke.

[39]  K. Morgan,et al.  Prevalence, frequency, and duration of hypnotic drug use among the elderly living at home , 1988, British medical journal.

[40]  B. J. Alpers Cerebrovascular Disorders , 1981, Brain and Development.

[41]  T. Brugha,et al.  SCAN. Schedules for Clinical Assessment in Neuropsychiatry. , 1990, Archives of general psychiatry.

[42]  M. Åsberg,et al.  A New Depression Scale Designed to be Sensitive to Change , 1979, British Journal of Psychiatry.

[43]  M. Aldrich,et al.  Sleep apnea in acute cerebrovascular diseases: final report on 128 patients. , 1999, Sleep.

[44]  A. King,et al.  Prevalence of self-reported poor sleep in a healthy population aged 50-65. , 1992, Social science & medicine.

[45]  R. Robinson,et al.  The neuropsychiatry of stroke. , 2000, Psychosomatics.

[46]  David Lee Gordon,et al.  Classification of Subtype of Acute Ischemic Stroke: Definitions for Use in a Multicenter Clinical Trial , 1993, Stroke.

[47]  V. Mohsenin,et al.  Sleep-Related Breathing Disorders and Risk of Stroke , 2001, Stroke.

[48]  J. Rodin,et al.  A longitudinal study of depressed mood and sleep disturbances in elderly adults. , 1988, Journal of gerontology.