Abstract
Inappropriate sleep duration and poor sleep quality are associated with risk of stroke, but their interactive effect on stroke is unknown. We explored the interactive effect of sleep quality and duration on stroke risk. A prospective cohort study was conducted with 41,786 adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sleep duration was measured by average hours of sleep per night. Cox regression models were used to calculate the association of sleep duration and quality with stroke. The delta method and a non-conditional logistic regression model were used and the relative excess risk due to interaction (RERI), the attributable proportion (AP), and the synergy index (S) were calculated. Compared with sleep duration 6–8 h/day, the risk ratio of stroke was 1.63 (1.23–2.11) times for sleep duration <6 h/day and 1.40 (1.08–1.75) times for >8 h/day. The stroke risk ratio was 2.37 (1.52–3.41) times in subjects with poor sleep quality compared with those with good sleep quality. Women who slept <6 h/day had higher stroke risk than men who slept <6 h/day. Men who slept >8 h/day had higher stroke risk than women who slept >8 h/day. Men with poor sleep quality had higher stroke risk than women with poor sleep quality. Stroke was associated with short/long sleep duration and poor sleep quality in subjects aged >46 years, compared with those aged 18–45 years. Stroke occurred more frequently in subjects with poor sleep quality combined with short sleep duration (odds ratio: 6.75; 95% confidence interval (CI): 2.45–14.12). RERI, AP, and S values (and their 95% CIs) were 5.54 (3.75–8.12), 0.72 (0.56–0.80), and 5.69 (4.23–9.90) for the poor sleep quality interact with short sleep duration. In persons with poor sleep quality accompanied by long sleep duration, RERI, AP, and S (95% CI) were 1.12 (1.01–1.27), 0.35 (0.26–0.51), and 2.05 (1.57–2.96), respectively. Subjective sleep disturbances are related with risk of stroke in Chinese adults. There are additive interactions between short/long sleep duration and poor sleep quality that affect risk of stroke.
Highlights
Inappropriate sleep duration and poor sleep quality are associated with risk of stroke, but their interactive effect on stroke is unknown
Some studies have shown that stroke is associated with poor sleep quality and sleep duration[6,7,8], while others have insistent results[9,10], which might partly due to different races[11]
Our study showed that poor sleep quality and sleep duration (8 h/d) increased the risk of being stroke independent of the potential confounders in a Chinese population
Summary
Inappropriate sleep duration and poor sleep quality are associated with risk of stroke, but their interactive effect on stroke is unknown. The stroke risk ratio was 2.37 (1.52–3.41) times in subjects with poor sleep quality compared with those with good sleep quality. Stroke was associated with short/long sleep duration and poor sleep quality in subjects aged >46 years, compared with those aged 18–45 years. There are additive interactions between short/long sleep duration and poor sleep quality that affect risk of stroke. Identifying and describing the relationship, and implementing early intervention measures to are extremely important in modifying the risk factor and in further slowing the progression of the disease in China To this end, the current study aims to examine the effects and the interactive effect of sleep quality and sleep duration on stroke, respectively, in Chinese adults
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
