De Lott Lindsey B, Lisabeth Lynda D, Sanchez Brisa N, Morgenstern Lewis B, Smith Melinda A, Garcia Nelda M, Chervin Ronald, Brown Devin L
Stroke Program, The Cardiovascular Center - Stroke Program, 1500 E. Medical Center Drive - SPC#5855, Ann Arbor, MI 48109-5855, USA.
Stroke Program, The Cardiovascular Center - Stroke Program, 1500 E. Medical Center Drive - SPC#5855, Ann Arbor, MI 48109-5855, USA; Department of Epidemiology, 1014 SPH I, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
Sleep Med. 2014 Dec;15(12):1582-5. doi: 10.1016/j.sleep.2014.09.007. Epub 2014 Sep 28.
The ethnic disparity in ischemic stroke between Mexican Americans (MAs) and non-Hispanic whites (NHWs) may be partly attributable to disparities in sleep and its disorders. We therefore assessed whether pre-stroke sleep apnea symptoms (SA risk) and pre-stroke sleep duration differed between MAs and NHWs.
MA and NHW ischemic stroke survivors in the Brain Attack Surveillance in Corpus Christi (BASIC) project reported sleep duration and SA symptoms on the validated Berlin questionnaire, both with respect to their pre-stroke baseline. Log binomial and linear regression models were used to test the unadjusted and adjusted (demographics and vascular risk factors) associations of high-risk Berlin scores and sleep duration with ethnicity.
Among 862 subjects, 549 (63.7%) were MA and 514 (59.6%) had a high risk of pre-stroke SA. The MA and NHW subjects showed no ethnic difference, after adjustment for potential confounders, in pre-stroke SA risk (risk ratio (95% confidence interval (CI)): 1.06 (0.93, 1.20)) or in pre-stroke sleep duration (on average MAs slept 2.0 fewer minutes than NHWs, 95% CI: -18.8, 14.9 min).
Pre-stroke SA symptoms are highly prevalent, but ethnic differences in SA risk and sleep duration appear unlikely to explain ethnic stroke disparities.
墨西哥裔美国人(MA)和非西班牙裔白人(NHW)在缺血性卒中方面的种族差异可能部分归因于睡眠及其障碍方面的差异。因此,我们评估了MA和NHW在卒中前睡眠呼吸暂停症状(SA风险)和卒中前睡眠时间是否存在差异。
科珀斯克里斯蒂脑卒中新发监测(BASIC)项目中的MA和NHW缺血性卒中幸存者在经过验证的柏林问卷上报告了睡眠时间和SA症状,均针对其卒中前基线情况。使用对数二项式和线性回归模型来检验未调整和调整后(人口统计学和血管危险因素)的高风险柏林评分及睡眠时间与种族的关联。
在862名受试者中,549名(63.7%)为MA,514名(59.6%)有卒中前SA的高风险。在对潜在混杂因素进行调整后,MA和NHW受试者在卒中前SA风险(风险比(95%置信区间(CI)):1.06(0.93,1.20))或卒中前睡眠时间方面(平均而言,MA比NHW少睡2.0分钟,95%CI:-18.8,14.9分钟)没有种族差异。
卒中前SA症状非常普遍,但SA风险和睡眠时间的种族差异似乎不太可能解释种族间的卒中差异。