AUTHOR=Liu Fei , Yang Yang , Wang Shuo , Zhang Xiao-Li , Wang An-Xin , Liao Xiao-Ling , Fang Hong-Juan , Qu Yue , Ma Wei-Guo , Zhang Ning , Wang Chun-Xue , Wang Yong-Jun 

TITLE=Impact of Sleep Duration on Depression and Anxiety After Acute Ischemic Stroke

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.630638

DOI=10.3389/fneur.2021.630638

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Abnormal sleep duration predicts depression and anxiety. We seek to evaluate the impact of sleep duration before stroke on the occurrence of depression and anxiety at 3 months after acute ischemic stroke (AIS).</p><p><bold>Methods:</bold> Nationally representative samples from the Third China National Stroke Registry were used to examine cognition and sleep impairment after AIS (CNSR-III-ICONS). Based on baseline sleep duration before onset of stroke as measured by using the Pittsburgh Sleep Quality Index (PSQI), 1,446 patients were divided into four groups: &gt;7, 6–7, 5–6, and &lt;5 h of sleep. Patients were followed up with the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) for 3 months. Poststroke anxiety (PSA) was defined as GAD-7 of ≥5 and poststroke depression (PSD) as PHQ-9 of ≥5. The association of sleep duration with PSA and PSD was evaluated using multivariable logistic regression.</p><p><bold>Results:</bold> The incidences of PSA and PSD were 11.2 and 17.6% at 3 months, respectively. Compared to a sleep duration of &gt;7 h, 5–6 h, and &lt;5 h of sleep were identified as risk factors of PSA [odds ratio (OR), 1.95; 95% confidence interval (CI), 1.24–3.07; <italic>P</italic> &lt; 0.01 and OR, 3.41; 95% CI, 1.94–6.04; <italic>P</italic> &lt; 0.01) and PSD (OR, 1.47; 95% CI, 1.00–2.17; <italic>P</italic> = 0.04 and OR, 3.05; 95% CI, 1.85–5.02; <italic>P</italic> &lt; 0.01), while 6–7 h of sleep was associated with neither PSA (OR, 1.09; 95% CI, 0.71–1.67; <italic>P</italic> = 0.68) nor PSD (OR, 0.92; 95% CI, 0.64–1.30; <italic>P</italic> = 0.64). In interaction analysis, the impact of sleep duration on PSA and PSD was not affected by gender (<italic>P</italic> = 0.68 and <italic>P</italic> = 0.29, respectively).</p><p><bold>Conclusions:</bold> Sleep duration of shorter than 6 h was predictive of anxiety and depression after ischemic stroke.</p>