Skip to main content

ORIGINAL RESEARCH article

Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 16 - 2024 | doi: 10.3389/fnagi.2024.1509846
This article is part of the Research Topic Sleep and Neurodegeneration View all 4 articles

Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study

Provisionally accepted
Ying Wu Ying Wu 1*Ting Fu Ting Fu 1Weiwei Zhang Weiwei Zhang 2Rongrong Guo Rongrong Guo 1Shuang He Shuang He 2Saiying Yu Saiying Yu 1Huiying Wang Huiying Wang 1Yunfeng Zhang Yunfeng Zhang 2
  • 1 School of Nursing, Capital Medical University, Beijing, China
  • 2 Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Background: Hypocretin-1 is a vital neurotransmitter in regulating the sleep-wake cycle and provides neuroprotection against cerebral ischemia. We aims to develop a poor sleep quality predictive model for elderly population with acute ischemic stroke. Methods: A total of 183 consecutively elderly patients were included in the prospective cohort study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Cerebrospinal fluid samples were taken within 24 hours of acute ischemic stroke onset. After selecting optimal predictors via univariate analysis and bootstrapped stepwise logistic regression, the predictive model was developed. The models were internally validated and evaluated comprehensively via discrimination, calibration, and clinical utility. Results: The prevalence of poor sleep (PSQI >7) was 64.5% among elderly individuals experiencing acute ischemic stroke. The study developed a predictive model using hypocretin-1, hypertension, stroke history, the National Institutes of Health Stroke score, and depression. Adding hypocretin-1 (as continuous variable) significantly improved the model performance greatly, as the area under the receiver operating characteristic curve increased from 0.799 to 0.845 (p < 0.001). The optimal cutoff value for hypocretin-1 was 74.94 pg/ml. Adding hypocretin-1 (as binary variable) significantly improved the model performance greatly, as the AUC increased from 0.799 to 0.857 (p < 0.001). Conclusion: Reduced cerebrospinal fluid levels of hypocretin-1 at admission were an independent poor sleep quality predictor and the model demonstrated superior performance. The combination of hypocretin-1 could offer valuable prognostic information for post-stroke sleep quality in elderly patients with acute ischemic stroke.

    Keywords: Hypocretin-1, sleep quality, Depression, Acute ischemic stroke, Elderly

    Received: 11 Oct 2024; Accepted: 12 Dec 2024.

    Copyright: © 2024 Wu, Fu, Zhang, Guo, He, Yu, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ying Wu, School of Nursing, Capital Medical University, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.