The characteristics of sleep disturbance in patients with comorbid anxiety and depression after cerebral infarction and their related factors

Abstract

Objective To investigate the factors influencing sleep disturbance and comorbid anxiety and depression after cerebral infarction.Methods A total of 216 patients with first onset of cerebral infarction were enrolled and divided into a post-stroke comorbid anxiety and depression (PSCAD) group, a pure anxiety group, a pure depression group and a non-anxiety and no-depression group. Smoking, alcohol intake, educational background, life or work pressure and exercise frequency were compared among the four groups along with ultrasound images of the carotid artery and brain blood vessels. The subjects' sleep quality was evaluated with the Pittsburgh sleep quality index (PSQI).Results The conditions studied showed no significant difference among the four groups. There were significant differences among the four groups in HAMA and HAMD scores. HAMD overall scores were higher in the PSCAD group than in the other three groups. HAMA overall scores were higher in the PSCAD group than in the pure depression group or the non-anxiety and no-depression groups. The PSCAD group showed significantly higher scores on all the dimensions and in their overall scores than those in the non-anxiety and no-depression group. Subjective sleep quality, sleep latency, sleep duration, sleep efficiency, day-time dysfunction and the overall PSQI score were all significantly higher in the PSCAD group than in the pure anxiety group. Sleep latency, sleep duration, day-time dysfunction and the overall PSQI scores were significantly higher in the PSCAD group than in the pure depression group. Age, life or work pressure, smoking, alcohol intake were the main factors influencing sleep quality in the PSCAD group.Conclusions The sleep quality of anxious and depressed patients after cerebral infarction is worse than that of those suffering only anxiety or depression alone, especially in terms of subjective sleep quality, sleep latency, sleep duration, sleep efficiency and day-time dysfunction. Age, life or work pressure, smoking and alcohol intake are the main factors influencing sleep quality in such comorbid individuals after cerebral infarction. Key words: Cerebral infarction; Anxiety; Depression; Sleep quality; Comorbidity