The following is a summary of “Pre-morbid sleep disturbance and its association with stroke severity: results from the international INTERSTROKE study,” published in the March 2024 issue of Neurology by McCarthy et al.
Researchers conducted a retrospective study to examine whether pre-existing sleep problems influence the seriousness of strokes and patients’ ability to function afterward.
They conducted INTERSTROKE, an international case-control study of the first acute stroke, involving 2,361 cases who completed a standardized questionnaire on nine symptoms of sleep disturbance in the month before the stroke. From this, two indices were derived for sleep disturbance (range 0–9) and obstructive sleep apnea (range 0–3). Logistic regression determined the association between symptoms and stroke severity, as defined by the modified Rankin Score.
The results showed that participants had a mean age of 62.9 years, with 42% female. A graded association was found between an increasing number of sleep disturbance symptoms and initially severe stroke (2–3: OR 1.44, 95% CI 1.07–1.94; 4–5: OR 1.66, 95% CI 1.23–2.25; >5: OR 2.58, 95% CI 1.83–3.66). Having >5 sleep disturbance symptoms significantly increased the odds of functional deterioration at 1 month (OR 1.54, 95% CI 1.01–2.34). A higher obstructive sleep apnea score also correlated with significantly increased odds of initially severe stroke (2–3: OR 1.48, 95% CI 1.20–1.83) but not functional deterioration at 1 month (OR 1.19, 95% CI 0.93–1.52).
Investigators concluded that since sleep problems were prevalent and linked to worse stroke outcomes, modifying sleep habits could be a future target for preventing severe strokes and improving recovery.