Persisting Short or Long Sleep Duration Predicts Post-Stroke Depression One year After Stroke and Transient Ischemic Attack
Bibliographic record
Abstract
Yang Hu,1,* Lijun Zuo,1,* Yuesong Pan,2 Hongyi Yan,2 Yongjun Wang,1 Xingquan Zhao1 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xingquan Zhao, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South Fourth Ring West Road, Fengtai District, Beijing, People’s Republic of China, 100070, Tel +0086-010-59978350, Fax +0086-010-59973383, Email zxq@vip.163.comObjective: Disrupted sleep duration is associated with the risk of stroke, and abnormal sleep duration predicts depression. However, the association of changes in sleep duration with functional outcome and depression after acute ischemic stroke (AIS) or transient ischemic attack (TIA) is still unclear.Methods: All patients diagnosed with AIS or TIA in the impairment of cognition and sleep (ICONS) from the China National Stroke Registry III were included. Post-stroke depression (PSD) was defined as a value on the Patient Health Questionnaire-9 (PHQ-9) ≥ 5. Sleep duration was classified as normal (7– 8 hours), short (< 7 hours), or long (≥ 9 hours). According to the sleep duration, patients were divided into four groups: group A (persisting normal), group B (changed from long or short to normal), group C (changed from normal to long or short), and group D (persisting long or short). Logistic regression was performed to evaluate the effects of sleep duration changes on PSD, quality of life, and functional outcome at 1-year follow-ups.Results: A total of 1450 AIS or TIA patients at baseline with a mean age of 60.73± 10.82 years were followed for 1-year. The group with persisting long or short sleep duration exhibited a significantly higher risk of PSD [OR 1.58(95% CI (1.06~2.33)] and poor quality of life [OR 1.42(95% CI 1.04~1.94)] than those in the persisting normal group at 1-year after AIS and TIA when adjusted for covariates. Patients with a decreased sleep duration of > 1 hour had more risk of moderate to severe PSD [OR 2.26(95% CI 1.13~4.53)] than the persisting normal group. Patients with newly developed abnormal sleep duration (changed from normal to long or short) had a higher risk of poor functional outcome [OR 2.82(95% CI 1.33~5.96)] than the persisting normal group.Conclusion: The alterations in sleep duration were independently associated with PSD, poor quality of life, and adverse outcomes at 1-year, suggesting that inadequate sleep quantity plays an important role in 1-year depression, quality of life, and adverse outcomes after AIS or TIA.Keywords: mild stroke, persisting cognitive impairment, Montreal cognitive assessment-Beijing, functional dependence
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".