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Han FY, Shao YJ, Liang Y, Zhang MY, Lu NJ. Vividness of visual imagery is associated with the effect of relaxation response meditation training in elderly people with nonorganic insomnia: A randomized, double-blind, multi-center clinical trial. Exp Gerontol 2024; 194:112486. [PMID: 38879094 DOI: 10.1016/j.exger.2024.112486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND This study aims to explore the efficacy of Relaxation Response Meditation Training (RRMT) on elderly individuals with different levels of vividness of visual imagery. METHODS In this randomized controlled, double-blind, multi-center clinical trial, we recruited a total of 136 elderly individuals who were over 60 years with nonorganic sleep disorders to participate in a 4-week RRMT intervention from October 2020 to October 2022. The intervention occurred twice a week, totaling eight times. These individuals were divided into high and low groups based on the vividness of visual imagery, and then randomly assigned to either the control or intervention groups, as follows: low-visualizers intervention group (LI group); low-visualizers control group (LC group); high-visualizers intervention group (HI group); high-visualizers control group (HC group). Their social and psychological parameters were assessed before and after the intervention by the Pittsburgh Sleep Quality Index (PSQI), the Revised Piper's fatigue scale (RPFS), General well-being scale (GWB), and Satisfaction rating. The alpha waves of patients were also collected through electroencephalogram to assess their level of relaxation. RESULTS Compared to the LI group, the HI group had a greater reduction rate in the PSQI score [25.2 % (18.8 % to 31.7 %), P < 0∙001], shorter sleep latency (P = 0.001), lower frequency of sleep medication (P < 0.001), lower PSQI scores (P < 0.001), and higher GWB scores (P < 0.001). There were significant differences in all indicators in the HI group vs. HC group and in the LI group vs. LC group. In the first five relaxation training sessions, there was no statistically significant difference in the proportion of α waves between the LI group and the LC group; however, from the sixth session onward, we observed a statistically significant difference (t = 2.86, P = 0.019),while The HI group and HC group showing significant differences in the first relaxation training session (t = 4.464, P < 0.001). There was a statistically significant difference in subjective satisfaction between the intervention group and the control group (x2 = 49.605, P < 0.001). CONCLUSION In this study, we found that most elderly people benefitted from RRMT regardless of their vividness of visual imagery. However, low-visualizers experienced slower and less effective results, so these patients may benefit more from alternative approaches.
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Affiliation(s)
- Fu-Yu Han
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing 100017, China.
| | - Yu-Jing Shao
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing 100017, China
| | - Yan Liang
- Zhumadian Traditional Chinese Medicine Hospital, Henan Province 463000,China
| | - Ming-Yue Zhang
- Beidaihe Rest and Recuperation Center of PLA, Qinhuangdao 066001, China
| | - Nan-Jun Lu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing 100017, China
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Zhang H, Yang J, Gu R, Yang J, Dong X, Ren Z, Sun S, Wang X, Wei S, Zhuo Z, Liu Z, Wang C. Healthy diet habits attenuate the association of poor sleep quality with nonfatal ischemic stroke: A prospective rural cohort. Nutrition 2024; 126:112485. [PMID: 39096779 DOI: 10.1016/j.nut.2024.112485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/08/2024] [Accepted: 05/01/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVES The combined impact of sleep quality and diet habits on ischemic stroke remains unclear, particularly in rural populations. Therefore, this study aimed to estimate the individual and joint associations of sleep quality and diet habits with nonfatal ischemic stroke among rural adults. METHODS A total of 22 536 participants free of stroke were enrolled from the Henan Rural Cohort. Sleep quality and diet habits were evaluated with the Pittsburgh Sleep Quality Index and food frequency questionnaire, respectively. The ischemic stroke incidence was analyzed using Kaplan-Meier curves. Cox regression and restricted cubic spline were employed to estimate the correlation of sleep quality or diet habits with ischemic stroke. RESULTS During an average 3.92 y of follow-up, 665 ischemic stroke patients were identified. The adjusted hazard ratio (95% confidence interval) of ischemic stroke risk compared with good sleep quality was 1.276 (1.057-1.542). The hazard ratio (95% confidence interval) of nonfatal ischemic stroke compared with unhealthy diet habits was 0.693 (0.589-0.814). The restricted cubic spline indicated that the risk of ischemic stroke increased with the increase of the Pittsburgh Sleep Quality Index. And the higher the diet quality score, the lower the risk of ischemic stroke. (Ptrend < 0.05). Further analysis indicated that the association of poor sleep quality with ischemic stroke was alleviated by healthy diet habits (P < 0.05). Additionally, a robust correlation remained after excluding individuals with ischemic stroke in the first year. CONCLUSIONS Poor sleep quality was positively associated with nonfatal ischemic stroke among rural adults, and healthy diet habits attenuated this relationship. Developing healthy diet and sleep habits may have potential health implications for preventing ischemic stroke. TRIAL REGISTRATION The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (registration no. ChiCTR-OOC-15006699). Date of registration: July 6, 2015.
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Affiliation(s)
- Hui Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jing Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Ruiqi Gu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Jiao Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiaokang Dong
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zhihan Ren
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Siyuan Sun
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiaoyu Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shouzheng Wei
- Department of Clinical Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zhuang Zhuo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Zihan Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
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Amalia L, Garyani MD, Lailiyya N. Increasing of Cortisol Level and Neutrophil-Lymphocyte-Ratio are Associated with Severity Level and Sleep Disturbances in Acute Ischemic Stroke. Int J Gen Med 2023; 16:5439-5448. [PMID: 38021057 PMCID: PMC10676643 DOI: 10.2147/ijgm.s439149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023] Open
Abstract
Background Acute ischemic stroke can cause sleep disturbances. These complaints involve various factors, such as disturbances of the hormone cortisol and Neutrophil-Lymphocyte-Ratio (NLR) that can cause increasing severity levels in acute ischemic stroke patients. This study aimed to determine the relationship between cortisol levels and NLR with severity levels and sleep disturbances in acute ischemic stroke patients. Methods A cross-sectional analytic observational study was conducted on acute ischemic stroke patients during Agustus - December 2022. Examine cortisol levels using the ELISA method, NLR from blood test, asses severity levels using the National Institute of Health Stroke Scale (NIHSS), and The Pittsburgh Sleep Questionnaire Index (PSQI) is used as a measure for the initial screening of sleep disturbances-statistical analysis using Spearman correlation. Results Total study subjects were 48 patients, with the majority 62.5% women; the mean age of study subjects was above 60 years (56.3%), and the most common type of stroke was large artery atherosclerotic stroke (77.1%), the highest NIHSS score was in the moderate category (85.4%), the most common risk factor is hypertension (64.4%), and basal ganglia area is the most common ischemic stroke location (52.1%). There was a positive correlation between cortisol levels with NIHSS (r=0.874; p-value <0.001), NLR with sleep disturbances (r=0.829; p-value<0.001), NLR with NIHSS (r=0.893; p-value<0.001), and NIHSS with PSQI (r=0.836; p-value<0.001). Conclusion There were a positive correlation between cortisol level, NLR level, and NIHSS score with sleep quality disturbances based on PSQI in acute ischemic stroke patients.
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Affiliation(s)
- Lisda Amalia
- Department of Neurology, Medical Faculty, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Mitha Dewi Garyani
- Department of Neurology, Medical Faculty, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Nushrotul Lailiyya
- Department of Neurology, Medical Faculty, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
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Tian H, Wang L, He Q, Xu X, Zhang Y, Yang J, Ye H, Jiang L. Association between sleep quality and cardiovascular disease in maintenance hemodialysis patients: a prospective cohort study. Ren Fail 2023; 45:2278310. [PMID: 37936488 PMCID: PMC10653692 DOI: 10.1080/0886022x.2023.2278310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/29/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the association between sleep quality and cardiovascular disease in patients on maintenance hemodialysis (MHD). METHODS A total of 601 patients with MHD in the second affiliated hospital of Nanjing Medical University, were prospectively enrolled in this cohort study from January 2019 to December2019. The global Pittsburgh sleep quality index (PSQI) score > 7 indicates that a person with poor sleep quality. Patients were divided into two groups according to the PSQI score. Follow-up was conducted about 3 years with all-cause death and major adverse cardiovascular events (MACEs) as the endpoint events. RESULTS Of the 601 patients, 595 patients completed the PSQI assessment, with 278 patients having poor sleep quality. Patients in the PSQI > 7 group were older and had a higher proportion of cardiovascular disease or diabetes. Years of education, diastolic blood pressure, and heart rate were lower in the PSQI > 7 group. At a mean follow-up period of 3 years, 116 patients died, 64 patients were lost to follow-up, and 115 patients experienced MACEs. After adjusting for confounding factors such as age, gender, dialysis age, and previous cardiovascular disease, the risk of MACE in patients with poor sleep quality was twice that of patients with good sleep quality (HR = 2.037 (1.339, 3.097), p = 0.001). There was no significant difference in the risk of all-cause death between the two groups. CONCLUSION The prevalence of poor sleep quality was 46.7% in patients with MHD. Poor sleep quality was an independent risk factor for MACEs in patients with MHD.
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Affiliation(s)
- Han Tian
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lulu Wang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qingyun He
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xinxin Xu
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yan Zhang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Junwei Yang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Ye
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Jiang
- Center for Kidney Disease, The second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Luo Y, Yu G, Liu Y, Zhuge C, Zhu Y. Sleep quality after stroke: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33777. [PMID: 37335687 DOI: 10.1097/md.0000000000033777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Sleep-related problems are debilitating and long-lasting conditions in individuals with stroke. We aimed to estimate the prevalence of poor sleep quality after stroke by conducting a systematic review and meta-analysis. METHODS Five databases (PubMed, Embase, Web of Science, Scopus, and CINHAL) were searched for literature published before November 2022. Studies recruiting participants with stroke, using a validated scale to measure sleep quality and in English were included. We used the Agency for Healthcare Research and Quality Scale and Newcastle-Ottawa Scale to assess the quality of eligible studies. Pooled prevalence and subgroup analyses were performed to understand the variation in sleep quality among studies. We followed the PRISMA checklist to report the study. RESULTS Thirteen studies were included for analysis (n = 3886). The pooled prevalence of poor sleep quality was 53% (95% CI 41-65%). Studies using PSQI with a cutoff point of 7 had a prevalence of 49% (95% CI 26-71%), whereas those with a cutoff point of 5 had a higher prevalence of 66% (95% CI 63-69%) (P = .13). Geographical location could explain the prevalence variation between studies. The majority of included studies had a medium level quality of evidence (10/13). CONCLUSION Poor sleep quality appears to be common in patients with stroke. Considering its negative impact on health, effective measures should be taken to improve their quality of sleep. Longitudinal studies should be conducted to examine the contributing factors and investigate the mechanisms that lead to poor sleep quality.
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Affiliation(s)
- Ye Luo
- Quzhou College of Technology, Quzhou, China
| | - Guofeng Yu
- Department of Brain Surgery, People's Hospital of Quzhou, Quzhou, China
| | - Yuanfei Liu
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Chengjun Zhuge
- Department of Brain Surgery, People's Hospital of Quzhou, Quzhou, China
| | - Yinge Zhu
- Affiliated Zhongshan Hospital Fudan University, Shanghai, China
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Kwon HS, Kim C, Kim YS, Koh SH, Kim HY, Lee SH, Jung KH, Kim JM, Kim YD, Kwon HM, Koo DL, Kim BJ, Kim BJ, Heo SH, Chang DI, Bushnell CD. Long Sleep Duration and Dissatisfaction with Sleep Quality Are Associated with Ischemic Stroke in Young Patients. Cerebrovasc Dis 2023; 52:671-678. [PMID: 36944320 DOI: 10.1159/000530003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/01/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION Suboptimal sleep duration and poor sleep quality have been proposed to increase stroke risk. However, their significance in young ischemic stroke is unclear. We aimed to investigate the importance of sleep duration and quality on young ischemic stroke patients. METHODS A multicenter matched case-control study was performed to evaluate under-recognized risk factors in young (<45 years) ischemic stroke patients in 8 tertiary hospitals in Korea. A total of 225 patients and 225 age- and sex-matched controls were enrolled in the same period. Detailed information about patients' demographics, socioeconomic state, and traditional and nontraditional risk factors including sleep-related factors were obtained using structured questionnaires. Risk of ischemic stroke was estimated using conditional logistic regression analysis. RESULTS Although average sleep duration was similar in patients and controls, patients were more likely to have long (≥9 h) or extremely short (<5 h) sleep durations. In addition, the proportion of subjects with dissatisfaction with sleep quality was higher in patients than controls (66.2 vs. 49.3%, p < 0.001). In multivariable conditional logistic regression analysis, long sleep duration (OR: 11.076, 95% CI: 1.819-67.446, p = 0.009) and dissatisfaction with sleep quality (OR: 2.116, 95% CI: 1.168-3.833, p = 0.013) were independently associated with risk of ischemic stroke. CONCLUSIONS Long sleep duration and dissatisfaction with sleep quality may be associated with increased risk of ischemic stroke in young adults. Improving sleep habit or quality could be important for reducing the risk of ischemic stroke.
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Affiliation(s)
- Hyuk Sung Kwon
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea,
| | - Chulho Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Young Seo Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Seong-Ho Koh
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Hyun Young Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Seung-Hoon Lee
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong-Min Kim
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dae Lim Koo
- Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Beom Joon Kim
- Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Hyuk Heo
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Dae-Il Chang
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Cheryl D Bushnell
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Jacobs MM, Ellis C. Stroke in women between 2006 and 2018: Demographic, socioeconomic, and age disparities. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231199061. [PMID: 37735849 PMCID: PMC10515531 DOI: 10.1177/17455057231199061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Black Americans have a higher prevalence of stroke and stroke-related deaths than any other racial group. Racial disparities in stroke outcomes are even wider among women than men. Conventional studies have cited differences in lifestyle (i.e. smoking, alcohol consumption, etc.) and vascular risk factors between races as the source of these disparities. However, these studies fail to account for the higher prevalence of minoritized populations at the lower end of the socioeconomic distribution. OBJECTIVES This study explores differences in stroke risk factors across age and socioeconomic cohorts to determine whether comorbidities can sufficiently explain disparities at all ages and income levels. DESIGN Using the 2006-2018 National Health Interview Survey data, statistical analysis evaluated differences in risk factors among a full sample cohort (aged 18-85 years; n = 131,091) and a "young" subsample cohort (aged 18-59 years; n = 6183) of women. METHODS Logistics and unconditional quantile regression models assessed the relationship between stroke and comorbid, demographic, and behavioral characteristics across socioeconomic classes. RESULTS Results suggest that Black women had a 1.415-fold (confidence interval = 1.259, 1.591) higher likelihood of stroke compared with White women after controlling for age, behavior, and comorbidities. Racial disparities were not statistically significant at the higher income ranges for either the full (odds ratio = 1.404, p = 0.3114) or young samples (odds ratio = 1.576, p = 0.7718). However, Blacks had significantly higher odds of stroke in the lower quartiles (lower odds ratio: 1.329, p = 0.0242; lower middle odds ratio: 1.233, p = 0.0486; and upper middle odds ratio: 1.994, p = 0.0005). Disparities were larger among young women (odds ratio = 1.449, confidence interval = 1.211, 1.734). CONCLUSION While comorbidities were highly associated with stroke prevalence in all socioeconomic cohorts, Blacks only had higher relative odds in the lower income classes. Lack of biological or behavioral explanations for these findings suggests that unobserved or uncontrolled factors such as systemic racism, prejudicial institutions, or differential treatment may contribute to this.
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Affiliation(s)
- Molly M Jacobs
- Department of Health Services Research, Management & Policy, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
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Silva LAS, Amaral MMD, Grassi V, Palmeira ALR. Chronic insomnia disorder as risk factor for stroke: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1159-1166. [PMID: 36577416 PMCID: PMC9797278 DOI: 10.1055/s-0042-1755227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Stroke is one of the main causes of mortality worldwide. Nonetheless, there are still risk factors that have not been fully elucidated, such as chronic insomnia disorder. OBJECTIVE To evaluate the association between chronic insomnia disorder and the risk of stroke in adults, through a systematic review. METHODS Multiple studies available in the Embase, Lilacs, and Medline platforms were evaluated in English, Spanish, French, and Portuguese. The selection of papers was restricted to those that had investigated the association between chronic insomnia disorder and stroke in adults, regardless of gender or nationality, without a previous history of stroke. The data was extracted with the Cochrane Effective Practice and Organization of Care (EPOC) form. The risk of bias was evaluated by the EPOC Risk of bias tool. RESULTS A total of 138 articles were identified. After a detailed evaluation with the eligibility criteria, four articles were included in the present systematic review. Three of them recognized the association between chronic insomnia disorder and stroke. The comparative analysis was limited, since the studies used distinct insomnia classifications. Regarding the risk of bias, the analysis displayed an important risk in the selection and allocation of participants, besides the use of own insomnia diagnosis criteria, disrespecting chronology and factors indicated by already established classifications. CONCLUSIONS There is not enough data to determine that chronic insomnia disorder is a risk factor for stroke. The present study points out the existence of a possible relationship between insomnia disorder and stroke, suggesting that further studies adopt standardized criteria and instruments.
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Affiliation(s)
| | - Mateus Molin do Amaral
- Universidade do Vale do Taquari, Centro de Ciências Médicas, Lajeado, Brazil.,Address for correspondence Mateus Molin do Amaral
| | - Vanise Grassi
- Universidade do Vale do Taquari, Centro de Ciências Médicas, Lajeado, Brazil.
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Wu X, Zou Y, You S, Zhang Y. Distribution of risk factors of ischemic stroke in Chinese young adults and its correlation with prognosis. BMC Neurol 2022; 22:26. [PMID: 35030995 PMCID: PMC8759205 DOI: 10.1186/s12883-022-02552-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The risk factors for ischemic stroke in young people are complex, varied and closely related to prognosis. This study aims to analyze the risk factors for ischemic stroke in Chinese young people and to explore the main factors influencing the prognosis. METHOD A total of 444 patients aged 16 to 45 years with ischemic stroke admitted to Suzhou tertiary hospital from 2011 to 2019 were retrospectively analyzed. Risk factors were identified according to the IPSS definition of pediatric stroke and the TOAST classification. All patients were followed up, and the modified Rankin score was used to evaluate the prognosis. Logistic regression analysis was used to explore the influencing factors of poor prognosis. RESULTS Among the patients, 12 risk factors were found according to the IPSS definition of pediatric stroke, and 5 types of stroke were found according to the TOAST classification. A total of 299 patients had a good prognosis. Anemia, venous sinus thrombosis, isolated large-vessel occlusion, and high baseline NIHSS score were significant risk factors. CONCLUSION The IPSS definition enables patients to be classified on the basis of more risk factors than other classification methods. The prognosis of ischemic stroke in young people is generally good in the 5 years following the event. Anemia, venous sinus thrombosis, isolated large-vessel occlusion and high baseline NIHSS score were associated with poor prognosis.
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Affiliation(s)
- Xiaoke Wu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yutian Zou
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shoujiang You
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yanlin Zhang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Qiu X, Han NS, Yao JX, Yu FR, Lin YY, Zhuang X. Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study. Front Aging Neurosci 2021; 13:698988. [PMID: 34483881 PMCID: PMC8414891 DOI: 10.3389/fnagi.2021.698988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/20/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Post-stroke insomnia (PSI) affects the quality of life for stroke patients, reduces the likelihood of successful rehabilitation, and produces additional complications following stroke. Previous reports have provided some information regarding PSI risk factors, but little is known concerning protective factors for PSI. This study analyzed the relationship between acupuncture and insomnia in stroke patients and explored the use of acupuncture as a preventive treatment. Methods: Patients diagnosed with stroke from 2010 to 2019 were identified in the case database of the First Affiliated Hospital of Guangzhou University of Chinese These patients followed until 2020, and numerous factors were examined, including gender, age, stroke type, stroke location, and baseline comorbidities. A 1:1 propensity score was used to match an equal number of patients receiving acupuncture with stroke patients who did not receive acupuncture (N = 1,680 for each group). The purpose of the study was to compare the incidence of insomnia in these two stroke cohorts. We used the Cox regression model and Kaplan-Meier method to estimate the risk of insomnia as the outcome event. Results: Compared with the non-acupuncture cohort in general, stroke patients who received acupuncture treatment exhibited a lower risk of insomnia after adjusting for age, gender, stroke type, stroke location, and comorbidities (adjusted hazard ratio HR = 0.27, 95% confidential interval = 0.23 to 0.32). Acupuncture also reduced the risk of PSI for both genders. The respective risks were HR = 0.28 (adjusted) for males and HR = 0.26 (adjusted) for females. Acupuncture also lowered the risk for PSI for different age groups. The risks were HR = 0.22 (adjusted) for individuals 18 to 39 years of age, HR = 0.31 (adjusted) for individuals 40 to 59 years of age, HR = 0.28 (adjusted) for those 60 to 79 years of age, and HR = 0.18 (adjusted) for individuals 80 years of age and older. Concerning the stroke type, regardless of whether the stroke was ischemic, hemorrhagic, or a combination of the two stroke types, patients who received acupuncture exhibited lower risk (adjusted HR = 0.28, 0.17, and 0.49, respectively). Concerning stroke location, except for the cerebral hemispheres (adjusted HR = 1.10, 95% confidential interval = 0.12 to 1.01), the risk of PSI after receiving acupuncture was lower for the frontal lobe (adjusted HR = 0.42), the basal ganglia (adjusted HR = 0.22), the radiation crown (adjusted HR = 0.42), the diencephalon (adjusted HR = 0.20), or multiple partial strokes (adjusted HR = 0.26), the risk of PSI after receiving acupuncture was lower. For all baseline complications, acupuncture reduced the risk of insomnia. The cumulative incidence of insomnia in the acupuncture cohort was significantly lower than the non-acupuncture cohort (log-rank test, P = 0.000). Limitations: First, our research only included patients from a single center. Second, we did not classify the post-stroke insomnia severity. Second, the information was extracted manually. Overall, the sample size was small, and we needed to increase the sample size to strengthen the conclusions. Conclusion: Acupuncture treatment reduced the risk of insomnia in stroke patients. Future research be conducted with increased sample sizes and further elaboration on the specific acupuncture protocols that were used.
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Affiliation(s)
- Xuan Qiu
- Acupuncture and Rehabilitation Clinical School, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Nan Sheng Han
- Acupuncture and Rehabilitation Clinical School, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Jie Xiao Yao
- Acupuncture and Rehabilitation Clinical School, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Fang Rui Yu
- Acupuncture and Rehabilitation Clinical School, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Yan Yan Lin
- Department of Traditional Chinese Medicine, The Second Clinical Medical College, Guangdong Medical University, Dongguan, China
| | - Xun Zhuang
- The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
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11
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Song X, Peng J, Jiang W, Ye M, Jiang L. Effects of aromatherapy on sleep disorders: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25727. [PMID: 33907165 PMCID: PMC8084014 DOI: 10.1097/md.0000000000025727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The progress of modern society and changes in lifestyle have not only increased the proportion of sub-healthy people, but also caused many people to suffer from sleep disorders and mental anxiety. Long-term lack of high-quality sleep will not only cause psychological problems such as anxiety and fatigue, but also cause physical abnormalities, such as abnormal hormone secretion, weakened immunity, neuroendocrine disorders, and high blood pressure. Therefore, the purpose of this study is to systematically evaluate the effectiveness of aromatherapy in improving sleep quality in people with sleep disorders. METHODS Computer search CNKI, SinoMed, Wanfang, PubMed, Web of science, and EMbase collect randomized controlled trials on aromatherapy to improve sleep quality of people with sleep disorders. The search time limit is to build the database until April 5, 2021. RevMan5.3 software is used for meta-analysis. RESULTS This systematic review will provide an assessment of the current state of sleep disorders, aiming to assess the efficacy of aromatherapy for patients with sleep disorders. CONCLUSION This systematic review will provide a credible evidence-based for the clinical treatment of sleep disorders with aromatherapy.
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Affiliation(s)
- Xin Song
- College of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine
| | - Jiahua Peng
- Institute of Obstetrics and Gynecology of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine Nanchang, Jiangxi Province
| | - Weiyu Jiang
- College of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine
| | - Minghua Ye
- National College of Beijing University of Traditional Chinese Medicine, Beijing
| | - Lisheng Jiang
- Institute of Health Preservation, Jiangxi University of Traditional Chinese Medicine Nanchang 330006, Jiangxi Province, China
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12
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Zhao B, Wu Y, Jin X, Yang L, Yang J, Ma X, Yan B. Objectively Measured Sleep Characteristics and Incidence of Ischemic Stroke: The Sleep Heart Health Study. Nat Sci Sleep 2021; 13:1485-1494. [PMID: 34466047 PMCID: PMC8403018 DOI: 10.2147/nss.s313891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/12/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Sleep disorders are associated with the prevalence of stroke. However, there is limited evidence regarding the association between objectively measured sleep characteristics and ischemic stroke. METHODS Ischemic stroke was assessed during the mean follow-up period of 11 years in the Sleep Heart Health Study. Sleep parameters such as wake after sleep onset (WASO) and sleep efficiency (SE) were objectively measured based on in-home polysomnography records. Multivariable Cox regression analysis was utilized to examine the relationship between objective sleep characteristics and ischemic stroke incidence. RESULTS This study involved 4204 participants (1978 males and 2226 females, 63.8±11.1 years). The incidence of ischemic stroke increased in individuals with long WASO, poor SE, and short sleep duration. Multivariable Cox regression analysis showed that WASO within the fourth quartile (hazard ratio [HR] 3.771, 95% confidence interval [CI] 1.805-7.877, P<0.001), third quartile (HR 3.009, 95% CI 1.433-6.317, P=0.004), and second quartile (HR 3.108, 95% CI 1.470-6.568, P=0.003) had a higher incidence of ischemic stroke than WASO within the first quartile. Poor SE (<80.0%) was also found to be a predictor for ischemic stroke (HR 2.220, 95% CI 1.244-3.960, P=0.007). Additionally, a short sleep duration (<6 h) was associated with an increased risk of ischemic stroke (HR 1.725, 95% CI 1.026-2.899, P=0.040). CONCLUSION Our results revealed a relationship between WASO, SE, and sleep duration and ischemic stroke. Therefore, these sleep characteristics may be adequate predictors for the incidence of ischemic stroke.
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Affiliation(s)
- Binbin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yanhua Wu
- Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiaoying Jin
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Lihong Yang
- Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jian Yang
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.,Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Bin Yan
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.,Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
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13
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Xiao M, Huang G, Feng L, Luan X, Wang Q, Ren W, Chen S, He J. Impact of sleep quality on post-stroke anxiety in stroke patients. Brain Behav 2020; 10:e01716. [PMID: 33140545 PMCID: PMC7749555 DOI: 10.1002/brb3.1716] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/05/2020] [Accepted: 05/24/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To explore whether poor sleep is associated with post-stroke anxiety (PSA) in Chinese patients with acute ischemic stroke (AIS) and to verify whether poor sleep is a predictor of PSA. METHODS A total of 327 patients with AIS were enrolled and followed up for 1 month. Sleep quality within 1 month before stroke was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at admission. The patients were divided into the poor sleep group (PSQI > 7, n = 76) and good sleep group (PSQI ≤ 7, n = 251). One month after stroke, patients with obvious anxiety symptoms and a Hamilton Anxiety Scale score >7 were diagnosed with PSA. RESULTS Eighty-seven patients (26.6%) were diagnosed with PSA. Compared to the good sleep quality group, the incidence of PSA in patients with poor sleep quality was higher (42.1% vs. 21.9%, p = .001). Poor sleep quality is more common in patients with PSA (35.6% vs. 18.8%, p = .001). A logistic regression analysis indicated that poor sleep quality was significantly associated with PSA (OR: 2.265, 95% CI: 1.262-4.067, p = .003). After adjusting for conventional and identified risk factors, poor sleep quality was found to be independently associated with PSA (OR: 2.676, 95% CI: 1.451-4.936, p = .001). CONCLUSIONS Poor sleep quality before stroke was associated with PSA and may be an independent risk factor of PSA 1 month after AIS onset.
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Affiliation(s)
- Meijuan Xiao
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guiqian Huang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liang Feng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoqian Luan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qiongzhang Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Siyan Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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14
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Ji A, Lou H, Lou P, Xu C, Zhang P, Qiao C, Yang Q. Interactive effect of sleep duration and sleep quality on risk of stroke: An 8-year follow-up study in China. Sci Rep 2020; 10:8690. [PMID: 32457400 PMCID: PMC7250859 DOI: 10.1038/s41598-020-65611-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/01/2020] [Indexed: 12/22/2022] Open
Abstract
Inappropriate sleep duration and poor sleep quality are associated with risk of stroke, but their interactive effect on stroke is unknown. We explored the interactive effect of sleep quality and duration on stroke risk. A prospective cohort study was conducted with 41,786 adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sleep duration was measured by average hours of sleep per night. Cox regression models were used to calculate the association of sleep duration and quality with stroke. The delta method and a non-conditional logistic regression model were used and the relative excess risk due to interaction (RERI), the attributable proportion (AP), and the synergy index (S) were calculated. Compared with sleep duration 6-8 h/day, the risk ratio of stroke was 1.63 (1.23-2.11) times for sleep duration <6 h/day and 1.40 (1.08-1.75) times for >8 h/day. The stroke risk ratio was 2.37 (1.52-3.41) times in subjects with poor sleep quality compared with those with good sleep quality. Women who slept <6 h/day had higher stroke risk than men who slept <6 h/day. Men who slept >8 h/day had higher stroke risk than women who slept >8 h/day. Men with poor sleep quality had higher stroke risk than women with poor sleep quality. Stroke was associated with short/long sleep duration and poor sleep quality in subjects aged >46 years, compared with those aged 18-45 years. Stroke occurred more frequently in subjects with poor sleep quality combined with short sleep duration (odds ratio: 6.75; 95% confidence interval (CI): 2.45-14.12). RERI, AP, and S values (and their 95% CIs) were 5.54 (3.75-8.12), 0.72 (0.56-0.80), and 5.69 (4.23-9.90) for the poor sleep quality interact with short sleep duration. In persons with poor sleep quality accompanied by long sleep duration, RERI, AP, and S (95% CI) were 1.12 (1.01-1.27), 0.35 (0.26-0.51), and 2.05 (1.57-2.96), respectively. Subjective sleep disturbances are related with risk of stroke in Chinese adults. There are additive interactions between short/long sleep duration and poor sleep quality that affect risk of stroke.
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Affiliation(s)
- Ailing Ji
- Department of Neurology, Xuzhou Third People's Hospital, 131 Huancheng Road, Xuzhou, 221000, Jiangsu, China
| | - Heqing Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221000, Jiangsu, China
| | - Peian Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221000, Jiangsu, China.
| | - Chunrong Xu
- Department of Neurology, Xuzhou Third People's Hospital, 131 Huancheng Road, Xuzhou, 221000, Jiangsu, China
| | - Pan Zhang
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221000, Jiangsu, China
| | - Cheng Qiao
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou, 221000, Jiangsu, China
| | - Qing Yang
- Department of Neurology, Xuzhou Third People's Hospital, 131 Huancheng Road, Xuzhou, 221000, Jiangsu, China
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15
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Okada K, Saito I, Katada C, Tsujino T. Influence of quality of sleep in the first trimester on blood pressure in the third trimester in primipara women. Blood Press 2019; 28:345-355. [PMID: 31266373 DOI: 10.1080/08037051.2019.1637246] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The purpose of this study was to clarify the relationship between decreased sleep quality during the first trimester and a rise in blood pressure during an otherwise normal course of pregnancy in primipara women. Materials and methods: We recruited 128 pregnant women (primipara) who visited the obstetrics and gynecology clinic for medical examination, of which 89 were longitudinally investigated from the first to the third trimester after obtaining informed consent. A survey was conducted in the first, second, and third trimesters to evaluate sleep quality using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J). Patients were assigned to either a good sleep quality group (PSQI-J ≤ 5) or a poor sleep quality group (PSQI-J ≥ 6). Blood pressure was measured using a home blood pressure measurement method. We analyzed the relationship between sleep quality in the first trimester and blood pressure during pregnancy. Results: The increase in morning systolic blood pressure from first to third trimester was larger in the poor sleep quality group than in the good sleep quality group (7.1 ± 7.0 vs. 3.0 ± 5.6 mmHg, p < .01). Sleep latency (r = 0.38, β = 0.43, p = .02) and sleep disturbances (r = 0.24, β = 0.33, p = .04) in the first trimester affected the increase in systolic blood pressure during pregnancy. Conclusions: Understanding sleep quality at the beginning of pregnancy can help predict a rise in systolic blood pressure in the third trimester. This emphasizes the importance of sleep education during pregnancy.
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Affiliation(s)
- Kimie Okada
- Graduate School of Health Sciences, Kobe University , Kobe , Japan.,Department of Nursing, School of Nursing, Hyogo University of Health Sciences , Kobe , Japan
| | - Izumi Saito
- Graduate School of Health Sciences, Kobe University , Kobe , Japan
| | - Chihiro Katada
- Department of Nursing, School of Nursing, Hyogo University of Health Sciences , Kobe , Japan
| | - Takeshi Tsujino
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences , Kobe , Japan
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16
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Park J. A study on the sleep quality, pain, and instrumental activities of daily living of outpatients with chronic stroke. J Phys Ther Sci 2019; 31:149-152. [PMID: 30858654 PMCID: PMC6382480 DOI: 10.1589/jpts.31.149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/07/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study is to examine the sleep quality, pain, and instrumental activities of daily living (IADL) of outpatients with chronic stroke, and to examine their correlation. [Participants and Methods] This study was conducted on 42 outpatients with chronic stroke, and data on their sleep quality, pain, and instrumental activities of daily living were collected and analyzed using the survey measurement tools. [Results] The analysis shows significant correlations among the sleep quality, pain, and instrumental activities of daily living of the outpatients with chronic stroke. [Conclusion] The findings of this study confirmed that the sleep quality and pain of outpatients with chronic stroke was related with their capacities of instrumental activities of daily living.
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Affiliation(s)
- JuHyung Park
- Department of Occupational Therapy, Health Science College, Cheongju University: 298 Daesung-ro, Cheongwon-gu, Cheongju 363-764, Republic of Korea
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17
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Wang J, Wang Z, Wang X, Du G, Zheng B, Li Y, Wang Q. Combination of Alprazolam and Bailemian Capsule Improves the Sleep Quality in Patients With Post-Stroke Insomnia: A Retrospective Study. Front Psychiatry 2019; 10:411. [PMID: 31231259 PMCID: PMC6567797 DOI: 10.3389/fpsyt.2019.00411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 05/23/2019] [Indexed: 12/22/2022] Open
Abstract
Insomnia is often ignored in the diagnosis and treatment of patients of stroke. The present study aimed to evaluate the efficacy of alprazolam (ALP) combined with Bailemian capsule (BC, a traditional Chinese patent medicine) in the treatment of post-stroke insomnia (PSI). A total of 231 stroke patients involved in this retrospective study were treated with ALP, BC, or ALP + BC for 3 weeks. The quality of sleep was evaluated by the Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG), while self-care ability was monitored by the modified Rankin Scale (mRS) before and after treatment. Compared with the baseline, the self-care ability of patients in each group was significantly improved after treatment (P < 0.01). The PSQI data showed a significant improvement in all patients in all of the subjective PSQI items and global score (P < 0.05). Notably, ALP + BC administration had a significantly greater effect on sleep latency, quality, disturbance, and efficiency, as well as daytime dysfunction and global PSQI than the use of ALP or BC alone (P < 0.05). The PSG data showed that ALP significantly improved the sleep efficiency and decreased the arousal times, rapid eye movement (REM) sleep, and sleep latency (P < 0.05), while BC significantly improved the sleep efficiency, total sleep time, and the duration of N3 (P < 0.05). Strikingly, ALP + BC achieved the effect of both ALP and BC (P < 0.05). Importantly, the effect of the combination of ALP and BC was greater than the use of ALP or BC alone, which was consistent with the result of PSQI. In conclusion, the sleep quality and self-care ability of patients with PSI were improved by ALP and BC, thereby supporting the potential advantages of ALP combined with BC in the treatment of patients with PSI.
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Affiliation(s)
- Jian Wang
- Department of Neurology, Yaan People's Hospital, Yaan, China
| | - Zhiqiang Wang
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Xiaoyan Wang
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Guo Du
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Bo Zheng
- Department of Neurology, Yaan People's Hospital, Yaan, China
| | - Yuxia Li
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Qingsong Wang
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
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