Association between sleep disorder and depression in stroke in the National Health and Nutrition Examination Surveys (NHANES) 2005 to 2014

Background: To investigate the association between sleep disorder and depression in stroke population using data from the National Health and Nutrition Examination Surveys (NHANES) conducted between 2005 and 2014. Methods: Participants included stroke population who reported on sleep disorder and completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptom. Sleep disorder was self-reported and categorized dichotomously. Multivariate logistic regression, subgroup analysis, receiver operating characteristic curve (ROC) and restricted cubic spline (RCS) were used to explore the association between sleep disorder and depression. Results: The final sample included 566 stroke survivors (weighted n = 3,326,625). Multivariate logistic regression analysis confirmed that sleep disorder was independently associated with an increased risk of depression even after adjusting for potential confounders (OR = 2.616, 95 % CI: 2.561 to 2.599, P < 0.0001). Subgroup analysis indicated that this association was particularly strong among female stroke population (OR = 5.515). Sleep disorder as a significant predictor of depression, while the relationship between sleep time and depression is characterized by non-linearity. Conclusions: Sleep disorder is significantly associated with an increased risk of depression in stroke. This relationship remains robust across various sociodemographic and lifestyle factors, highlighting the need for integrated interventions targeting both sleep and mood disturbances in stroke care.