title: Is insomnia associated with suicidality in stroke?
abstract: OBJECTIVE
  To evaluate the relationship between insomnia and suicidality (SI) in Chinese patients with first or recurrent stroke.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Acute stroke unit of a general hospital.
  
  
  METHODS
  Patients (N=787) with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Suicidality (SI) was assessed with the Geriatric Mental State Examination at 3 months after subjects' index stroke. Insomnia symptoms were evaluated with a standard insomnia questionnaire. The association between insomnia symptoms and SI was examined and adjusted for potential confounders, including age, sex, marital status, previous stroke, depression, fatigue, Mini-Mental State Examination score, and neurologic deficits measured with the National Institutes of Health Stroke Scale.
  
  
  RESULTS
  Eighty-seven patients (11.1%) were found to have SI (SI group). Frequent awakening was significantly more common in the SI group than in the non-SI group and remained a significant predictor of SI in forward logistic regression analysis (odds ratio, 1.7) after adjusting for possible confounders.
  
  
  CONCLUSIONS
  These findings should alert clinicians to the potential danger of insomnia and the importance of its early identification and treatment in stroke patients.
authors: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. tangwk@cuhk.edu.hk
authors: Wai-Kwong
authors: WK
authors: Tang
authors: Jin-Yan
authors: JY
authors: Lu
authors: Huajun
authors: H
authors: Liang
authors: Tsz Ting
authors: TT
authors: Chan
authors: Tse-Ting
authors: TT
authors: Chan
authors: Vincent
authors: V
authors: Mok
authors: Gabor S
authors: GS
authors: Ungvari
authors: Ka-Sing
authors: KS
authors: Wong
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D015999:Multivariate Analysis; D012008:Recurrence; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology; D059020:Suicidal Ideation