Role of vitamin D in the association between pre-stroke sleep quality and post-stroke depression and anxiety (vol 28, pg 841, 2024)

Purpose Poor sleep quality, mood disorders, and vitamin D defciency are common in stroke. We investigated the association between serum vitamin D levels and pre-stroke sleep quality and the occurrence of poststroke depression (PSD) and poststroke anxiety (PSA) in acute ischemic stroke (AIS). Methods This prospective cross-sectional study included hospitalized patients with AIS and age- and sex-matched controls. Vitamin D levels were measured within 24 h of admission. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at admission. The severity of depression and anxiety symptoms was evaluated according to Beck Depression Inventory and Beck Anxiety Inventory scores, respectively, within 72 h after admission. Results Comparing 214 AIS patients with 103 controls, patients had signifcantly higher scores of Beck Depression Inventory, Beck Anxiety Inventory, and PSQI and lower vitamin D levels (p<0.001). Among AIS patients, Beck Depression Inventory (p=0.004) and Beck Anxiety Inventory (p=0.018) scores were signifcantly higher in bad sleepers (PSQI score≥6) than in good sleepers (PSQI score≤5). Correlation analysis revealed negative correlations between serum vitamin D levels and Beck Depression Inventory (r= −0.234; p<0.001), Beck Anxiety Inventory (r= −0.135; p=0.016), and PSQI (r= −0.218; p<0.001) scores. Conclusion Decreased serum vitamin D levels at admission are associated with a high risk for PSD and PSA in patients with poor pre-stroke sleep quality during the early stages of AIS.