Is Insomnia Associated With Suicidality in Stroke?

Tang W-K, Lu J-Y, Liang H, Chan T-T, Mok V, Ungvari GS, Wong K-S. Is insomnia associated with suicidality in stroke? Objective To evaluate the relationship between insomnia and suicidality (SI) in Chinese patients with first or recurrent stroke. Design Cross-sectional survey. Setting Acute stroke unit of a general hospital. Participants Patients (N=787) with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong. Interventions Not applicable. Main Outcome Measures 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.