Depression symptoms best explained insomnia complaints after stroke - a cross-sectional study

Around 70 % of individuals in the acute phase and 40 % in the chronic phase post-stroke experience sleep-related issues. Considering the role of sleep in functional recovery, it becomes important to investigate the contribution of clinical factors to sleep quality in this population.

To investigate the proportion of individuals after stroke with insomnia complaints and whether variables, such as age, functional capacity, walking capacity, fatigue, depression, and quality of life would explain the presence of insomnia complaints.

An exploratory cross-sectional study, the dependent variable was insomnia complaints, measured by Insomnia Severity Index (ISI). A logistic regression analyzed the impact of age, functional capacity (mRS), walking capacity (6MWT), fatigue (FSS), depression (GDS), and quality of life (EuroQol) on insomnia complaints in individuals after stroke.

Ninety participants, 55 (61 %) men, with a mean age of 61 (12) years and a mean time since the onset of the stroke of 58.2 (58.7) months, were included. Twenty-eight (31 %) of them reported insomnia complaints. The analysis indicated that depression symptoms were the most influential factor, explaining 73 % of insomnia complaints (OR: 1.2, 95 %CI: 1.1 to 1.4).

One third of the participants had complaints of insomnia suggesting that is a relevant symptom after stroke. Depression, a modifiable factor, best explained insomnia complaints. Therefore, it is important to assess insomnia complaints and symptoms of depression during stroke rehabilitation, to improve patient outcomes. Future studies should further investigate the incidence and prediction of insomnia complaints after stroke.