From the College of Nursing & Health Innovation (M.E.P.), Arizona State University, Phoenix; Departments of Biostatistics (G.H.) and Epidemiology (V.J.H.), University of Alabama at Birmingham; Department of Psychiatry (M.A.G.), University of Arizona, Tucson; and Department of Neurology & Rehabilitation Medicine (D.K., J.R.M.), University of Cincinnati, OH.
Neurology. 2018 Oct 30;91(18):e1702-e1709. doi: 10.1212/WNL.0000000000006424. Epub 2018 Oct 3.
To investigate the association between reported sleep duration and incident stroke in a US cohort of black and white adults, and evaluate race, age, and sex as potential effect modifiers.
From 2008 to 2010, 16,733 black and white adults, aged ≥45 years, without a history of stroke or sleep-disordered breathing from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, reported their habitual sleep duration (<6, 6.0-6.9, 7.0-8.9 [reference], ≥9 hours). Incident strokes were identified through biannual participant contact followed by physician adjudication of medical records. Cox proportional hazards analysis was conducted to calculate hazard ratios of interactions between sleep duration with race, age, sex, and 2-way combinations of these factors on incident stroke adjusting for stroke risk factors and sleep-disordered breathing risk.
The sample comprised 10.4% (n = 1,747) short sleepers (<6 hours) and 6.8% (n = 1,134) long sleepers (≥9 hours). Over an average 6.1 years follow-up, 460 strokes occurred. There were significant interactions between sleep duration and race ( = 0.018) and sleep duration and race-sex groups ( = 0.0023) in association with incident stroke. Short sleep duration was significantly associated with decreased risk for stroke among black participants (hazard ratio [HR] 0.49 [95% confidence interval (CI) 0.28-0.85]), particularly black men (HR 0.21 [95% CI 0.07-0.69]), whereas long sleep duration was significantly associated with increased risk for stroke among white men (HR 1.71 [95% CI 1.06-2.76]).
The association of sleep duration with incident stroke differs by race and sex, with short sleep duration among black men associated with decreased risk, whereas long sleep duration among white men associated with increased risk for stroke.
在美国黑人和白人成年人队列中，调查报告的睡眠时间与中风事件之间的关联，并评估种族、年龄和性别是否为潜在的效应修饰剂。
2008 年至 2010 年，来自 Reasons for Geographic and Racial Differences in Stroke（REGARDS）研究的 16733 名年龄≥45 岁、无中风或睡眠呼吸障碍病史的黑人和白人成年人，报告了他们的习惯性睡眠时间（<6、6.0-6.9、7.0-8.9[参考值]、≥9 小时）。中风事件通过每两年一次的参与者联系和随后对医疗记录的医生判断来确定。采用 Cox 比例风险分析计算睡眠时间与种族、年龄、性别以及这些因素的 2 种组合之间的相互作用的危险比，以调整中风风险因素和睡眠呼吸障碍风险。
样本包括 10.4%（n=1747）的短睡眠者（<6 小时）和 6.8%（n=1134）的长睡眠者（≥9 小时）。在平均 6.1 年的随访期间，发生了 460 例中风。睡眠时间与种族（=0.018）和睡眠时间与种族-性别组（=0.0023）之间存在显著的相互作用，与中风事件相关。短睡眠时间与黑人参与者中风风险降低显著相关（危险比[HR]0.49[95%置信区间（CI）0.28-0.85]），尤其是黑人男性（HR 0.21[95%CI 0.07-0.69]），而长睡眠时间与白人男性中风风险增加显著相关（HR 1.71[95%CI 1.06-2.76]）。
睡眠时间与中风事件的关联因种族和性别而异，黑人男性的短睡眠时间与降低风险相关，而白人男性的长睡眠时间与增加中风风险相关。
