Development and validation of a nomogram diagnostic model for sleep disorders in stroke patients: A cross-sectional...

Stroke is a severe neurological disorder that significantly impacts patients' recovery and quality of life. Stroke patients frequently experience sleep disorders, including difficulty initiating sleep, insomnia, vivid dreams, and sleep apnea. These disorders not only disrupt nighttime rest but also significantly affect stroke recovery and prognosis, increasing the risks of recurrence and mortality. Currently, there are few studies on this topic, and most rely on Logistic regression models, which can identify risk factors but cannot quantify risks. Therefore, it is essential to develop a tool that can comprehensively assess multiple risk factors and provide individualized predictions. Nomogram models can quantify risk factors and intuitively present them, thereby providing clinicians with comprehensive assessments. This study aims to develop and validate a new nomogram model to predict the risk of sleep disorders in stroke patients, enabling early identification and personalized interventions to support patient recovery and improve quality of life. A cohort of 156 stroke patients (January-August 2023) was utilized for model development, comprising 70 with sleep disorders and 86 without. An external validation set included 72 patients (September-December), with 34 experiencing sleep disorders. Patient data was analyzed using Lasso regression; the "rms" package in R facilitated model construction. Model performance was assessed through Hosmer-Lemeshow goodness-of-fit tests, calibration curves, and receiver operating characteristic analyses. Gender bias, co-morbidities (hypertension and coronary heart disease), depression, and anxiety scales differentiated the groups significantly. Key predictors included female gender, hypertension, coronary heart disease, and psychological distress. The model yielded impressive predictive capabilities, with area under the curves of 0.950 (modeling group) and 0.966 (validation group). Calibration curves matched closely with ideals, confirming robustness across both sets. Net benefit rates indicated strong utility over a wide probability spectrum. Female gender, specific co-morbidities, heightened depressive and anxiety states signify elevated sleep disorder risks poststroke. Our nomogram effectively predicts these conditions, offering valuable insights for timely detection and intervention in susceptible stroke survivors.