A Dose-Response Relationship Between Sleep Duration and Stroke According to Nonhealth Status in Central China: A Population-based Epidemiology Survey

J Stroke Cerebrovasc Dis. 2019 Jul;28(7):1841-1852. doi: 10.1016/j.jstrokecerebrovasdis.2019.04.016. Epub 2019 May 7.

Abstract

Purpose: The aim was to investigate the relationship between sleep duration and stroke according to nonhealth status among adults in Central China.

Methods: A total of 18,670 participants were selected by stratified multistage random sampling method in Henan province during 2013-2015. Restricted cubic splines and logistic regression were used to calculate the association between sleep duration and stroke.

Results: Sleep duration showing a J-shaped dose-response association with risk of stroke among the Chinese adults in the study. The respective percentages of stroke were 6.2%, 5.6%, 3.5%, 4.5%, 5.6%, and 9.2% for those whose sleep duration less than 6 h/day, 6∼7 h/day, 7∼8 h/day, 8∼9 h/day, 9∼10 h/day, and more than or equal to 10 h/day. Compared with sleep duration of 7∼8 h/day, the risk of stroke increased by 37% (95% confidence interval [CI]: 8%, 73%) and 63% (95% CI: 30%, 104%) for those whose sleep duration were 9∼10 h/day and more than or equal to 10 h/day. The correlations between sleep durations and stroke seemed to be stronger in men than women. Stroke was associated with shorter sleep duration in ageing 60-88 years, instead of 18-59 years. The correlation between sleep duration and stroke was statistically significant at lower education level. Furthermore, the risk of stroke was slightly higher in urban residents than rural residents.

Conclusions: In summary, a J-shaped dose-response association between sleep duration and stroke was found among the adults in Central China. Furthermore, people who were male, older, less educated and living in urban areas had a higher risk of stroke.

Keywords: Sleep duration—stroke—dose-response association—population-based epidemiology survey.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Surveys
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / physiopathology
  • Sleep*
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Stroke / physiopathology
  • Time Factors
  • Urban Health
  • Young Adult