Abstract

Background: Insomnia is reported among stroke survivors but the prevalence in United States population has not been determined. Methods: Using a standard questionnaire, we examined trends and prevalence of insomnia in regards to moderate (5 to 15 times a month) to severe (16 to 30 times a month) difficulty in going to sleep and moderate (5 to 15 times a month) to severe (16 to 30 times a month) difficulty in maintaining sleep in a nationally representative sample of the United States population. Insomnia was classified via a combination of self-reported positive physician diagnosis and high-frequency of ’trouble falling asleep’, ’waking during the night’, ’waking too early’, and ’feeling un-rested during the day’. We analyzed 10887 subjects from 2005 to 2008 National Health and Nutrition Examination Survey (NHANES). Results: Moderate to severe difficulty in going to sleep (42[9.3%] versus 1097[10.5%], p-value = 0.31) and moderate to severe difficulty in maintaining sleep (52 [11.5%] versus 1258 [12.0%], p-value = 0.58) were observed among stroke survivors and those without stroke subjects, respectively. After adjustment for differences in age and gender, stroke subjects did not have any increase in risk of moderate to severe difficulty in going to sleep (odds ratio [OR] 1.2; 95% confidence interval [CI] 0.8 to 1.6) and moderate to severe difficulty in maintaining sleep (OR 1.1; 95% CI 0.8 to 1.5). Insomnia was observed in 117 (25.9%) stroke and 2651 (25.4%) non stroke survivors (OR 1.1; 95% CI 0.8-1.3). Conclusions: There is no significant increase in sleep initiation and sleep maintenance or insomnia among stroke survivors in the United States.

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