Is insomnia associated with suicidality in stroke?

Abstract

To evaluate the relationship between insomnia and suicidality (SI) in Chinese patients with first or recurrent stroke. Cross-sectional survey. Acute stroke unit of a general hospital. Patients (N=787) with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong. Not applicable. 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. 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. These findings should alert clinicians to the potential danger of insomnia and the importance of its early identification and treatment in stroke patients.