Genetically Predicted Sleep Traits and Functional Outcome After Ischemic Stroke: A Mendelian Randomization Study
Zhizhong Zhang1, Mengmeng Wang1, Dipender Gill1
1From the Department of Neurology (Z.Z., W.Z., X.L.), Jinling Hospital, Medical School of Nanjing University, China; Department of Neurology (M.W.), The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, China; and Department of Epidemiology and Biostatistics (D.G.), School of Public Health, St Mary's Hospital, Imperial College London, United Kingdom.
Neurology
|December 20, 2022
Summary
Genetic liability to insomnia is linked to poorer functional recovery after ischemic stroke. Addressing insomnia may improve outcomes for stroke survivors, warranting further clinical investigation.
Area of Science:
- Neuroscience
- Genetics
- Public Health
Background:
- Observational studies suggest sleep traits impact ischemic stroke recovery.
- Mendelian randomization (MR) is a robust method for investigating causal relationships.
- Understanding genetic predispositions to sleep disturbances is crucial for stroke outcomes.
Purpose of the Study:
- To explore the relationship between genetically predicted sleep traits and functional outcomes after ischemic stroke using MR.
- To determine if genetic liability to insomnia or altered sleep duration causally influences post-stroke recovery.
Main Methods:
- Utilized genome-wide association studies data for insomnia and sleep duration in European ancestry individuals.
- Employed the inverse-variance weighted approach as the primary MR analysis.
- Conducted sensitivity analyses using alternative MR methods and assessed heterogeneity with I² and Q statistics.
Main Results:
- Genetic liability to insomnia showed a significant association with worse functional outcome (modified Rankin Scale ≥3) post-stroke (OR=1.30, p=0.002).
- No significant associations were found between genetic liability to short sleep, long sleep, or continuous sleep duration and functional outcomes.
- Multivariable MR analyses, adjusting for confounders like BMI and depression, maintained the association between insomnia liability and poorer stroke recovery.
Conclusions:
- This MR study provides evidence for a potential causal link between liability to insomnia and adverse functional outcomes following ischemic stroke.
- Targeting insomnia through interventions may represent a promising therapeutic strategy to enhance recovery in ischemic stroke patients.
- Further clinical research is warranted to explore the efficacy of insomnia-focused interventions in improving post-stroke functional recovery.
