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Ethnic differences exist in sleepiness 3 Months after ischemic stroke.

Marri Horvat1, Lynda D Lisabeth2, Jaewon Lim3

  • 1Sleep Disorders Center, Department of Neurology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Sleep Medicine
|September 17, 2022
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Summary

Mexican American stroke survivors report worse subjective sleepiness (ESS) compared to non-Hispanic whites 90 days post-stroke. This ethnic disparity in sleep quality persists after adjusting for confounders.

Keywords:
EthnicityIschemic strokeSleep-disordered breathing

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Public Health

Background:

  • Subjective sleepiness significantly impacts quality of life after ischemic stroke.
  • Ethnic disparities in post-stroke outcomes are increasingly recognized.
  • The Epworth Sleepiness Scale (ESS) is a validated measure of subjective sleepiness.

Purpose of the Study:

  • To investigate the association between ethnicity and subjective sleepiness 90 days after ischemic stroke.
  • To compare sleepiness levels between Mexican American (MA) and non-Hispanic white (NHW) stroke survivors.
  • To identify potential ethnic disparities in post-stroke sleep quality.

Main Methods:

  • A cohort of MA and NHW ischemic stroke patients was identified from a population-based registry.
  • Subjects completed the Epworth Sleepiness Scale (ESS) at 90 days post-stroke.
  • Tobit regression models were used to assess the association between ethnicity and ESS, adjusting for confounders.

Main Results:

  • Mexican American (MA) survivors reported higher mean ESS scores (8.9) compared to non-Hispanic white (NHW) survivors (7.4) at 90 days.
  • After adjustment, MA survivors had significantly higher ESS scores (1.16 points) than NHW survivors.
  • The prevalence of excessive daytime sleepiness (ESS >10) was higher in MA (39%) than NHW (30%) survivors.

Conclusions:

  • Subjective sleepiness is significantly worse in Mexican American stroke survivors compared to non-Hispanic whites at 90 days post-stroke.
  • This ethnic disparity in sleepiness persists even after accounting for potential confounding variables.
  • Further research is needed to understand and address the underlying causes of this sleep quality disparity.