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Self-reported sleep disturbances among people who have had a stroke: a cross-sectional analysis
Matthew S Jeffers1, Alison C Pittman2, Tetyana Kendzerska2
1School of Epidemiology and Public Health (Jeffers, Kendzerska, Chen), University of Ottawa; Clinical Epidemiology Program (Jeffers, Kendzerska), Ottawa Hospital Research Institute; Department of Family Medicine (Pittman), University of Ottawa; Department of Medicine (Kendzerska), Ottawa Hospital Research Institute, University of Ottawa; Department of Cellular and Molecular Medicine (Corbett), University of Ottawa, Ottawa, Ont.; Departments of Physiotherapy and of Medicine, and Florey Institute of Neuroscience and Mental Health (Hayward), University of Melbourne, Melbourne, Australia mjeffers@ohri.ca.
Background:
Sleep disturbances and their potential association with stroke remains understudied at a population level. We sought to determine the prevalence of sleep disturbances among people who have effects of stroke compared with the general population.
Methods:
We used data from people aged 18 years or older who responded to the sleep and chronic disease modules of the 2017-2018 cycle of the Canadian Community Health Survey (CCHS). We measured sleep disturbances by self-reports of having trouble staying awake most or all of the time; either short (< 5 h) or long (> 9 h) nightly sleep duration; having trouble going to or staying asleep most or all of the time; and never, rarely or sometimes having refreshing sleep. We used log-binomial and multinomial regression to investigate prevalence of sleep disturbances among respondents who reported effects of stroke compared with others, adjusting for confounding factors.
Results:
We included 46 404 CCHS respondents, 682 of whom reported effects of stroke. The prevalence of sleep disturbances for those with effects of stroke was higher than among others in the sample with regard to trouble staying awake (13.0% v. 6.1%; adjusted relative risk [RR] 2.16, 95% confidence interval [CI] 1.59-2.94), short or long duration sleep (28.9% v. 10.0%; adjusted RR 1.93, 95% CI 1.57-2.38), trouble going to or staying asleep, (28.1% v. 17.6%; adjusted RR 1.53, 95% CI 1.28-1.83) and lack of refreshing sleep (41.1% v. 37.1%; adjusted RR 1.30, 95% CI 1.14-1.49). The prevalence of at least 1 reported measure of sleep disturbance was 61.6% among those with effects of stroke, compared with 48.2% among others (adjusted RR 1.28, 95% CI 1.18-1.40).
Interpretation:
Self-report of having effects of stroke was associated with increased prevalence of sleep disturbances compared with the general population. Sleep disturbances were reported by a high proportion of respondents with effects of stroke, indicating the importance of screening for related disorders.
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