Analysis of the correlation between sex and excessive daytime sleepiness in stroke patients

Background Excessive daytime sleepiness (EDS) is a common complication of stroke that has a detrimental effect on patients' daily life and functional recovery.The clinical and sleep-related factors of poststroke EDS may differ between males and females. Methods Stroke patients who participated in polysomnographic monitoring at Affiliated Hospital of Yangzhou University from February 2022 to September 2023 were included, and baseline data, laboratory tests, polysomnographic data, and related scale scores were retrospectively collected. The ESS (Epworth Sleepiness Scale) score and sex were used as the basis for grouping, and statistical analysis was performed using SPSS 26.0. Results Compared with females with EDS, female patients without EDS had lower white blood cell counts (p = 0.029); male patients with EDS had higher creatinine values than did those without EDS (p = 0.009); female patients with EDS had higher PSQI scores than did females without EDS vs. did males with EDS (p = 0.007; p = 0.034); and both male and female patients with EDS had poorer subjective sleep quality; and both male and female patients with EDS had higher daytime dysfunction scores than did those without EDS (p < 0.001); among female patients, depression scores (HADS-D) were greater in the EDS group than in the no-EDS group (p = 0.004); women with EDS had longer sleep latency (p = 0.002) and a shorter percentage of N2 sleep periods (p = 0.027) than did men with EDS did; Spearman correlation analysis related to ESS scores revealed a significant positive correlation between HADS-D scores and ESS scores in female patients (p = 0.001); and daytime dysfunction scores were significantly positively correlated with ESS scores in both male and female patients. (p < 0.001; p = 0.001). Conclusions Female patients suffering from daytime sleepiness have poorer sleep quality and more disturbed sleep architecture. Targeted development of different interventions is necessary, especially focusing on the psychological and sleep problems of female patients, and may further advance the treatment and prognosis of female stroke patients.