Pain and Sleep Disturbances are Associated with Post-stroke Anger Proneness and Emotional Incontinence

Background: Emotional disorders are common findings after a stroke episode. Despite evidence linking pain and sleep disorders to various post-stroke emotional conditions, their roles in the prevalence of post-stroke anger proneness (PSAP) and post-stroke emotional incontinence (PSEI) remain unclear. We investigated the influence of composite and different components of post-stroke pain (PSP) as well as post-stroke sleep disorders (PSSD) on PSAP and PSEI. Methods: Cross-sectional data on PSAP, PSEI, PSP and PSSD were evaluated through validated instruments and structured interviews for a total of 185 community-dwelling stroke survivors attending two Nigerian tertiary health facilities. Data on potential confounding variables were also assessed. Results: The rates of PSSD, PSP, PSAP and PSEI among Nigerian stroke survivors were 36.8%, 63.3%, 23.2% and 44.9%, respectively. The results of logistic regression models showed that composite PSP was associated with PSEI (adjusted odd ratio (aOR): 0.492; 95% confidence interval (CI): 0.251-0.965). While assessing the different components of PSSD and PSP, the results showed that sleep disturbances (aOR: 1.855; 95% CI: 1.096-3.140) and post-stroke headache (aOR: 0.364; 95% CI: 0.153-0.864) were associated with PSEI. In addition, being a domain of PSP, post-stroke headache was associated with PSAP (aOR: 0.052; 95% CI: 0.011-0.238). Conclusion: There is high prevalence of PSSD, PSP, PSAP and PSEI among Nigerian stroke survivors. Post-stroke headache is associated with both PSAP and PSEI, while sleep disturbances are associated with PSEI. Post-stroke headache and sleep disturbances are potential targets for interventions in patients with stroke to lessen the burden of PSAP and PSEI.