Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study
BackgroundHypocretin-1 is a vital neurotransmitter in regulating the sleep–wake cycle and provides neuroprotection against cerebral ischemia. We aims to develop a poor sleep quality predictive model for elderly population with acute ischemic stroke.MethodsA total of 183 consecutively elderly patient...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2024.1509846/full |
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| author | Ting Fu Weiwei Zhang Rongrong Guo Shuang He Saiying Yu Huiying Wang Yunfeng Zhang Ying Wu |
| author_facet | Ting Fu Weiwei Zhang Rongrong Guo Shuang He Saiying Yu Huiying Wang Yunfeng Zhang Ying Wu |
| author_sort | Ting Fu |
| collection | DOAJ |
| description | BackgroundHypocretin-1 is a vital neurotransmitter in regulating the sleep–wake cycle and provides neuroprotection against cerebral ischemia. We aims to develop a poor sleep quality predictive model for elderly population with acute ischemic stroke.MethodsA total of 183 consecutively elderly patients were included in the prospective cohort study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Cerebrospinal fluid samples were taken within 24 h of acute ischemic stroke onset. After selecting optimal predictors via univariate analysis and bootstrapped stepwise logistic regression, the predictive model was developed. The models were internally validated and evaluated comprehensively via discrimination, calibration, and clinical utility.ResultsThe prevalence of poor sleep (PSQI >7) was 64.5% among elderly individuals experiencing acute ischemic stroke. The study developed a predictive model using hypocretin-1, hypertension, stroke history, the National Institutes of Health Stroke score, and depression. Adding hypocretin-1 (as continuous variable) significantly improved the model performance greatly, as the area under the receiver operating characteristic curve increased from 0.799 to 0.845 (p < 0.001). The optimal cutoff value for hypocretin-1 was 74.94 pg/mL. Adding hypocretin-1 (as binary variable) significantly improved the model performance greatly, as the AUC increased from 0.799 to 0.857 (p < 0.001).ConclusionReduced cerebrospinal fluid levels of hypocretin-1 at admission were an independent poor sleep quality predictor and the model demonstrated superior performance. The combination of hypocretin-1 could offer valuable prognostic information for post-stroke sleep quality in elderly patients with acute ischemic stroke. |
| format | Article |
| id | doaj-art-b38eabd999014d5899bb80090c6172dc |
| institution | Kabale University |
| issn | 1663-4365 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj-art-b38eabd999014d5899bb80090c6172dc2025-01-07T06:49:32ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-01-011610.3389/fnagi.2024.15098461509846Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort studyTing Fu0Weiwei Zhang1Rongrong Guo2Shuang He3Saiying Yu4Huiying Wang5Yunfeng Zhang6Ying Wu7School of Nursing, Capital Medical University, Beijing, ChinaDepartment of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu, ChinaSchool of Nursing, Capital Medical University, Beijing, ChinaDepartment of Stroke Center, Affiliated Hospital of Nantong University, Nantong, Jiangsu, ChinaSchool of Nursing, Capital Medical University, Beijing, ChinaSchool of Nursing, Capital Medical University, Beijing, ChinaDepartment of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, ChinaSchool of Nursing, Capital Medical University, Beijing, ChinaBackgroundHypocretin-1 is a vital neurotransmitter in regulating the sleep–wake cycle and provides neuroprotection against cerebral ischemia. We aims to develop a poor sleep quality predictive model for elderly population with acute ischemic stroke.MethodsA total of 183 consecutively elderly patients were included in the prospective cohort study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Cerebrospinal fluid samples were taken within 24 h of acute ischemic stroke onset. After selecting optimal predictors via univariate analysis and bootstrapped stepwise logistic regression, the predictive model was developed. The models were internally validated and evaluated comprehensively via discrimination, calibration, and clinical utility.ResultsThe prevalence of poor sleep (PSQI >7) was 64.5% among elderly individuals experiencing acute ischemic stroke. The study developed a predictive model using hypocretin-1, hypertension, stroke history, the National Institutes of Health Stroke score, and depression. Adding hypocretin-1 (as continuous variable) significantly improved the model performance greatly, as the area under the receiver operating characteristic curve increased from 0.799 to 0.845 (p < 0.001). The optimal cutoff value for hypocretin-1 was 74.94 pg/mL. Adding hypocretin-1 (as binary variable) significantly improved the model performance greatly, as the AUC increased from 0.799 to 0.857 (p < 0.001).ConclusionReduced cerebrospinal fluid levels of hypocretin-1 at admission were an independent poor sleep quality predictor and the model demonstrated superior performance. The combination of hypocretin-1 could offer valuable prognostic information for post-stroke sleep quality in elderly patients with acute ischemic stroke.https://www.frontiersin.org/articles/10.3389/fnagi.2024.1509846/fullHypocretin-1sleep qualitydepressionacute ischemic strokeelderly |
| spellingShingle | Ting Fu Weiwei Zhang Rongrong Guo Shuang He Saiying Yu Huiying Wang Yunfeng Zhang Ying Wu Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study Frontiers in Aging Neuroscience Hypocretin-1 sleep quality depression acute ischemic stroke elderly |
| title | Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study |
| title_full | Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study |
| title_fullStr | Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study |
| title_full_unstemmed | Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study |
| title_short | Inclusion of hypocretin-1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke: a prospective cohort study |
| title_sort | inclusion of hypocretin 1 improved performance of poor sleep quality prediction for elderly patients with acute ischemic stroke a prospective cohort study |
| topic | Hypocretin-1 sleep quality depression acute ischemic stroke elderly |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2024.1509846/full |
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