Sleep disorders is the risk factor of stroke in traumatic brain injury patients

Background

Traumatic brain injury (TBI) is a major cause of death and disability in humans. The increased risk of stroke in TBI patients has been proved, and many studies indicated sleep disorders was a risk factor of stroke. Since sleep disorders are a common incidence symptom after TBI, it may be a pre-symptom for developing stroke. This study would like to understand if sleep disorders was a potential risk factor of stroke, and the related morbidity for special groups of TBI patients.

Methods

The Taiwan's national health insurance research database (NHIRD) was analyzed in this study. The Poisson regression was applied to calculate the incidence rate ratios of stroke with 95% confidence intervals between TBI patients with/without sleep disorder. The relative risks adjusted for potential confounding variables were estimated by the Cox regression.

Results

The overall incidence rate of new-onset stroke for TBI patients with sleep disorders is 150.83 per 10,000 person-years. TBI patients with sleep disorders have a 1.70-fold incidence rate ratio (p<0.0001) and increased HR of stroke (1.62, 95% confidence interval: 1.49-1.75) compared with those without sleep disorders. 

Conclusions 

This may be the first study about prevalence of sleep disorders in TBI patients for Asians. We also would like to examine the sleep disorders is a potential risk of stroke in TBI patients based on the powerful nationwide database. Therefore, we can suggest that physicians may pay more attention to the symptom of sleep disorders in TBI patients to prevent the development of stroke.