Abnormal Sleep Duration One Year After Stroke Linked to Higher Depression and Poor Recovery: Study Finds

The research, led by Dr. Yang Hu and colleagues from the Department of Neurology at Beijing Tiantan Hospital, Capital Medical University, Beijing, investigated how changes in sleep duration after an acute ischemic stroke (AIS) or TIA could influence long-term mental and functional outcomes.

The team analyzed data from the China National Stroke Registry III, focusing on patients enrolled in the Impairment of Cognition and Sleep (ICONS) study. A total of 1,450 individuals with AIS or TIA, with an average age of 60.73 years, were followed for one year. Sleep duration was self-reported and categorized as short (<7 hours), normal (7–8 hours), or long (≥9 hours). Based on sleep changes, patients were grouped as follows: those with stable normal sleep, those whose sleep normalized from initially short or long durations, those who developed abnormal sleep from a previously normal pattern, and those with persistently abnormal sleep.

The key findings were as follows:

• Individuals with persistent abnormal sleep (either short or long duration) were 58% more likely to develop post-stroke depression (PSD) compared to those with stable normal sleep.
• These individuals also had a 42% higher risk of experiencing poor quality of life after one year.
• Patients whose sleep duration decreased by more than one hour were over twice as likely to suffer from moderate to severe depression.
• Participants who developed new abnormal sleep patterns during the year were nearly three times more likely to have poor functional outcomes than those whose sleep remained normal.

According to the authors, the study is among the first to explore how dynamic changes in sleep duration affect depression and recovery following AIS or TIA. The findings emphasize the importance of addressing sleep health as a part of stroke recovery programs. “Sleep duration is a modifiable factor that may offer a valuable target for interventions aimed at improving post-stroke mental and functional outcomes,” the researchers noted.

However, the study also acknowledged certain limitations. Sleep duration was assessed via self-report rather than objective measures, such as polysomnography, which may affect accuracy. The authors recommend that future studies incorporate objective sleep assessments better to understand the link between sleep patterns and stroke recovery.

The authors conclude, "Maintaining a stable and healthy sleep duration of 7–8 hours may be critical for reducing the risk of depression and enhancing recovery after a stroke or TIA. Stroke education and rehabilitation programs should incorporate sleep health awareness and provide targeted support for those at risk of abnormal sleep patterns post-stroke."

Reference:

Hu Y, Zuo L, Pan Y, Yan H, Wang Y, Zhao X. Persisting Short or Long Sleep Duration Predicts Post-Stroke Depression One year After Stroke and Transient Ischemic Attack. Nat Sci Sleep. 2025;17:1507-1519

https://doi.org/10.2147/NSS.S492838