Clinical and radiologic correlates of insomnia symptoms in ischemic stroke patients.
OBJECTIVE
Insomnia is a common complaint in stroke survivors. The purpose of this study was to investigate the clinical and magnetic resonance imaging (MRI) correlates of insomnia symptoms in Chinese ischemic stroke survivors.


METHODS
A comprehensive psychiatric assessment was performed involving 508 ischemic stroke patients 3 months after their first-ever or recurrent acute stroke. Insomnia symptoms were evaluated with a standard insomnia questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS).The evaluation of the MRI scans focused on infarctions, white matter lesions, and microbleeds.


RESULTS
One hundred and eight-six patients (36.6% of the sample) had insomnia symptoms. Sixty-four patients (12.6%) had insomnia symptoms with daytime consequences. In the multivariate logistic regression analysis, GDS score (OR = 1.157, p < 0.001) and acute frontal lobe infarction (OR = 1.933, p = 0.039) were significant predictors of insomnia symptoms, while the GDS score (OR = 1.251, p < 0.001) and diabetes mellitus (OR = 1.959, p = 0.017) were significant predictors of insomnia symptoms with daytime consequences.


CONCLUSIONS
Insomnia symptoms have a multi-factorial origin in stroke. Besides depressive symptoms, frontal lobe infarction and diabetes mellitus predict insomnia symptoms.
Chen
Yang-Kun
YK
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
Lu
Jin-Yan
JY
Mok
Vincent C T
VC
Ungvari
G S
GS
Chu
Winnie C W
WC
Wong
Ka Sing
KS
Tang
Wai Kwong
WK
D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000473:pathology; D003866:Depressive Disorder / Q000150:complications; D005260:Female; D005625:Frontal Lobe; D015577:Geriatric Assessment; D006723:Hong Kong; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D020521:Stroke / Q000150:complications* / Q000473:pathology; D011795:Surveys and Questionnaires