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. 2024 Jul;14(3):242-252.
doi: 10.1177/19418744241231618. Epub 2024 Jan 31.

An Exploratory Analysis of Preclinical and Clinical Factors Associated With Sleep Disturbance Assessed via the Neuro-QoL After Hemorrhagic Stroke

Sarah Ecker  1 , Aaron Lord  1   2 , Lindsey Gurin  1   3   4 , Anlys Olivera  1   3 , Koto Ishida  1 , Kara R Melmed  1   2 , Jose Torres  1 , Cen Zhang  1 , Jennifer Frontera  1   2 , Ariane Lewis  1   2
Affiliations

An Exploratory Analysis of Preclinical and Clinical Factors Associated With Sleep Disturbance Assessed via the Neuro-QoL After Hemorrhagic Stroke

Sarah Ecker et al. Neurohospitalist. 2024 Jul.

Abstract

Background and purpose: Sleep disturbance after hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) can impact rehabilitation, recovery, and quality of life. We sought to explore preclinical and clinical factors associated with sleep disturbance after hemorrhagic stroke assessed via the Quality of Life in Neurological Disorders (Neuro-QoL) short form sleep disturbance inventory.

Methods: We telephonically completed the Neuro-QoL short form sleep disturbance inventory 3-months and 12-months after hemorrhagic stroke for patients >18-years-old hospitalized between January 2015 and February 2021. We examined the relationship between sleep disturbance (T-score >50) and social and neuropsychiatric history, systemic and neurological illness severity, medical complications, and temporality.

Results: The inventory was completed for 70 patients at 3-months and 39 patients at 12-months; 18 (26%) had sleep disturbance at 3-months and 11 (28%) had sleep disturbance at 12-months. There was moderate agreement (κ = .414) between sleep disturbance at 3-months and 12-months. Sleep disturbance at 3-months was related to unemployment/retirement prior to admission (P = .043), lower Glasgow Coma Scale score on admission (P = .021), higher NIHSS score on admission (P = .041) and infection while hospitalized (P = .036). On multivariate analysis, sleep disturbance at 3-months was related to unemployment/retirement prior to admission (OR 3.58 (95% CI 1.03-12.37), P = .044). Sleep disturbance at 12-months was related to premorbid mRS score (P = .046).

Conclusion: This exploratory analysis did not demonstrate a sustained relationship between any preclinical or clinical factors and sleep disturbance after hemorrhagic stroke. Larger studies that include comparison to patients with ischemic stroke and healthy individuals and utilize additional techniques to evaluate sleep disturbance are needed.

Keywords: intracerebral hemorrhage; modified Rankin scale score; sleep; subarachnoid hemorrhage; unemployment.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(A) Components of the neuro-QoL short form sleep disturbance inventory at 3-months (n = 70); (B) components of the neuro-QoL short form sleep disturbance inventory at 12-months (n = 39).
Figure 2.
Figure 2.
Patient selection.
Figure 3.
Figure 3.
Neuro-QoL short form sleep disturbance inventory T-score at 3-months (n = 70) and 12-months (n = 39).
Figure 4.
Figure 4.
Sleep disturbance after hemorrhagic stroke at 3-months and 12-months (n = 39).
See this image and copyright information in PMC

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