Healthy diet habit attenuated the association of poor sleep quality with non-fatal ischemic stroke: a prospective rural cohort

Abstract

ObjectiveThe combined impact of sleep quality and diet habit on ischemic stroke remains unclear, particularly in rural population. Therefore, this study aimed to estimate the single and joint associations of sleep quality and diet habit with non-fatal ischemic stroke among rural adults. MethodsA total of 22,536 participants free of stroke were enrolled from Henan Rural Cohort. Sleep quality and diet habit were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and food frequency question, respectively. The ischemic stroke incidence was analyzed using Kaplan-Meier curve. Cox regression and restricted cubic spline were employed to estimate the correlation of sleep quality or diet habit with ischemic stroke. ResultsDuring the average 3.92 years follows, 665 ischemic stroke patients were identified. Compared to good sleep quality, the adjusted hazard ratio (HR) and 95% confidence interval (CI) of ischemic stroke risk was 1.276 (1.057, 1.542). The HR (95% CI) of non-fatal ischemic stroke was 0.693 (0.589, 0.814) compared with unhealthy diet habit. The dose-response relationship of PSQI or diet quality score with ischemic stroke were found (Ptrend < 0.05). Further analysis indicated that the association of poor sleep quality with ischemic stroke was alleviated by healthy diet habit (P < 0.05). Additionally, a robust correlation remained after excluding individuals with ischemic stroke in the first year. ConclusionPoor sleep quality was positively associated with non-fatal ischemic stroke among rural adults, and healthy diet habit attenuated this relationship. Developing healthy diet and sleep habit may have potential health implications for preventing ischemic stroke. Trial registrationThe Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.