Influence of insomnia and its correction on the emotional state of post-stroke patients

Abstract

Introduction. Stroke is a major cause of morbidity and mortality in various populations. Sleep disturbances are common in patients who have suffered an acute cerebral circulatory disorder, complicating the recovery of motor functions, worsening the emotional state and being associated with poorer health and quality of life in general.Aim. To investigate the impact of sleep disturbance on the emotional state of stroke patients.Materials and methods. The study included 100 people who were divided into two groups. 50 patients who had suffered an acute cerebral circulatory disorder and who suffered from insomnia formed the main group, which was divided into 2 subgroups. MG1 – main subgroup 1 (26 people), who received a course of short-term (5 sessions) cognitive-behavioural therapy for insomnia in combination with the drug Valocordin-Doxylamine 25 mg as part of complex therapy. – MG2 main subgroup 2 (24 people), who received only standard treatment of the main disease. Patients in the comparison group who underwent acute cerebral circulatory disorder without concomitant insomnia (CG, 50 people) also received only standard treatment for the primary condition. In addition to clinical examination, the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Questionnaire (PSQI) and the Insomnia Severity Scale (ISI) were used to assess patients.Results. Initially, the main group had a statistically significant higher level of depression (clinically expressed depression) than the comparison group (subclinically expressed depression) (U = 54.6; p = 0.012). As a result of treatment in main subgroup 1, where insomnia was corrected, there was not only an improvement in sleep (median PSQI score before treatment 8 (6; 10) and after treatment 5 (5; 6), p = 0.022), but also a reduction in depression (HADS-D score before treatment 12 (10; 14) and after treatment 12 (10; 14)): 12 (10; 14) and post-treatment – 5 (4; 6), p = 0.022) and anxiety (HADS-A pre-treatment: 9 (7; 10) and post-treatment – 5 (4; 6), p = 0.013). In the main subgroup 2, where insomnia was not corrected, there was no improvement in sleep (PSQI before treatment 8 (6; 11) and after treatment 8 (7; 10), p = 0.433), depression (HADS-D before treatment: 9 (8; 11) and after treatment – 8 (6; 9), p = 0.171) and anxiety (HADS-A before treatment: 9 (6; 10) and after treatment – 8 (6; 9), p = 0.064) were less pronounced than in the main subgroup 1 and the comparison group (HADS-D: H (2, N = 100) = 25.73829, p = 0.016; HADS-A: H (2, N = 100) = 28.42621, p = 0.004).Conclusion. Complex therapy for stroke patients suffering from insomnia, including drug and non-drug methods of insomnia correction, increases the effectiveness of treatment by not only improving the quality of sleep, but also reducing the severity of anxiety and depression.