ArticleCureus2023
Prevalence and Outcomes of Depression, Obstructive Sleep Apnea, and Concurrent Anxiety (DOCA) in Stroke Survivors: Insights From a Nationwide Study.
Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 4 citations in OpenAlex.
- Post-intracerebral hemorrhage depression comorbid with obstructive sleep apnea and REM sleep behavior disorder: a case report and literature review.Frontiers in psychiatry · 2026Article
- A systematic review of obstructive sleep apnea in Indigenous peoples worldwide.Sleep advances : a journal of the Sleep Research Society · 2026Review
- Optimizing Identification and Management of Depression in Neurological Diseases: A Narrative Review and Expert Perspective.Neuropsychiatric disease and treatment · 2026Article
- The role of obstructive sleep apnea, neurofilaments and early CPAP intervention in post-stroke cognitive recovery.Sleep medicine: X · 2025Article
- Continuous positive airway pressure in acute ischemic stroke patients with obstructive sleep apnea: analysis of the National Inpatient Sample database.Frontiers in neurology · 2025Article
- Prevalence, incidence, and the time trends of sleep-disordered breathing among patients with stroke: a systematic review and meta-analysis.Frontiers in neurology · 2024Review
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Authors and funding
14 authors at 12 institutions in 4 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMany individuals will also experience psychological side effects after a stroke episode, such as symptoms of depression, anxiety (generalized anxiety disorder (GAD)), and/or specific phobias, considerably decreasing their quality of life (QOL).
objectiveThis study aimed to evaluate the prevalence of depression, obstructive sleep apnea (OSA), and concurrent anxiety (DOCA) and their outcomes (morbidity, disability (All Patient Refined Diagnosis Related Group (APRDRG) - loss of function), and discharge disposition) among acute ischemic stroke (AIS) hospitalizations.
methodsA cross-sectional study used the National Inpatient Sample (NIS) from 2003-2017. Adults with hospitalizations with AIS were extracted, and DOCA was identified using ICD-9/10-CM codes. Weighted analysis using a chi-square test and mixed-effect multivariable survey logistic regression was used to assess the prevalence and role of DOCA in predicting outcomes.
resultsOut of 5,690,773 AIS hospitalizations, 2.7%, 3.1%, and 4.4% had depression, OSA, and GAD, respectively. In AIS patients, females had a higher prevalence of depression (3.4% vs. 2.3%) and GAD (5.9% vs. 3.0%) and a quality of life lower prevalence of OSA (2.2% vs 4.4%) in comparison to males (p<0.0001). Caucasians had a higher prevalence of depression, OSA, and GAD in comparison to others (African Americans/Hispanics/Asians/Native Americans). Depressed patients had a higher prevalence of morbidity (9% vs. 8% vs 5% vs. 7%), disability (46% vs. 46% vs. 35% vs. 37%), transfer to non-home (69% vs. 58% vs. 61% vs. 63%) in comparison with OSA, GAD, and non-DOCA patients, respectively (p<0.0001). Depression was associated with a 40% higher chance of severe disability (aOR 1.40; 95% CI 1.38-41), morbidity (1.36; 1.33-1.38), and discharge to non-home (1.54; 1.52-1.56). OSA and GAD had higher odds of non-home discharge amongst post-AIS hospitalizations.
conclusionDOCA is associated with poor outcomes among post-AIS patients. Prompt recognition by screening and timely management of DOCA may mitigate the adverse outcomes.
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