Risk factors of sleep disorder after stroke: a meta-analysis

Objective: The study aimed to evaluate potential risk factors of sleep disorder in stroke patients by conducting a meta-analysis.Methods: Relevant articles were searched in PubMed, Medline, Springer, Elsevier, Science Direct, Cochrane Library, and Google scholar database up to May 2014. The effect size of risk factors, including gender, hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol use, previous stroke, chronic obstructive pulmonary disease (COPD), and habitual snoring were measured by odds ratio (OR) and corresponding 95% confidence interval (95% CI). The heterogeneity of effect size across studies was evaluated by applying Cochran’s Q-statistic and the I2 statistic. In addition, Egger’s linear regression test was used to evaluate the publication bias.Results: A total of 8 studies, involving 1381 stroke patients (578 patients with sleep disorder, and 803 patients without sleep disorder) were suitable for this meta-analysis. Pooled results showed significant association of sleep disorder risk in stoke patients with diabetes mellitus (OR = 1.42, 95% CI = 1.09–1.85), alcohol use (OR = 1.59, 95% CI = 1.19–2.12) and habitual snoring (OR = 14.77, 95% CI = 5.52–39.53). No significant association was found between risk of sleep disorder in stoke patients and other factors. Furthermore, heterogeneity was just presented among studies involving gender, hypertension and smoking. Egger’s linear regression test showed no statistical publication bias.Conclusion: Diabetes mellitus, alcohol use, and habitual snoring are associated with a significantly increased risk of sleep disorder in stroke patients.Highlights:(1) Eight studies containing 1381 patients are included in this meta-analysis.(2) Diabetes mellitus was associated with sleep disorder in stroke patients.(3) Alcohol use could increase the risk of sleep disorder in stroke patients.(4) Habitual snoring was obviously associated with sleep disorder in stroke patients.