College of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Department of Nutrition and Food Hygiene, College of Public Health, Harbin Medical University, Harbin, 150081, China.
Sleep Med. 2018 Dec;52:180-187. doi: 10.1016/j.sleep.2018.05.011. Epub 2018 May 24.
The joint effect of daytime naps and night sleep on the risk of stroke has not been clarified. Our research aimed to verify this relationship based on data from a large sample-sized cross-sectional study and a cohort study.
The cross-sectional study included 7887 subjects, aged 20-74 years. Using stratified random sampling, 1928 individuals were selected for the cohort study. We then followed up with these individuals for an average of 4.94 years and collected detailed sleep information with the Pittsburgh Sleep Quality Index (PSQI). Serum fasting blood glucose, triglyceride, cholesterol and high density lipoprotein were analyzed, and anthropometric measurements were taken. Interaction and joint analyses were performed.
Consistent with the results in the cross-sectional study, hazard ratios (HRs) (95% CI) of stroke were 1.94 (1.21-3.13) and 2.24 (1.05-4.79) for daytime napping ≥1 h and nighttime sleeping ≥9 h in the cohort study. For no naps combined with <7 h of nighttime sleeping, the HR (95%CI) was 2.61 (1.17-5.82). For ≥1 h of naps combined with <7 h, 7-8 h, 8-9 h, and ≥9 h of nighttime sleeping, HRs (95% CI) were 2.16 (1.03-4.51), 2.36 (1.07-5.20), 2.41 (1.11-5.20) and 3.37 (1.05-10.81), respectively.
Individuals with 7-8 h of night sleep combined with no daytime naps or less than 1 h of daytime napping were at low risk of stroke; nighttime sleeping ≥9 h combined with daytime napping ≥1 h and night sleep <7 h combined with 0 or >1 h daytime napping was associated with high risk of stroke. CLINICAL TRIAL REGISTRY: http://www.chictr.org.
ChiCTR-ECH-1200272, ChiCTR-ECH-12002938.
日间小睡和夜间睡眠对中风风险的综合影响尚未阐明。我们的研究旨在基于大型样本量的横断面研究和队列研究的数据来验证这种关系。
横断面研究纳入了 7887 名年龄在 20-74 岁的受试者。采用分层随机抽样方法，从该研究中选取了 1928 名个体进行队列研究。我们对这些个体进行了平均 4.94 年的随访，并使用匹兹堡睡眠质量指数（PSQI）收集了详细的睡眠信息。分析了血清空腹血糖、甘油三酯、胆固醇和高密度脂蛋白，并进行了人体测量。进行了交互和联合分析。
与横断面研究的结果一致，在队列研究中，日间小睡≥1 小时和夜间睡眠≥9 小时的中风风险比（HR）（95%CI）分别为 1.94（1.21-3.13）和 2.24（1.05-4.79）。对于无日间小睡且夜间睡眠<7 小时的情况，HR（95%CI）为 2.61（1.17-5.82）。对于日间小睡≥1 小时且夜间睡眠<7 小时、7-8 小时、8-9 小时和≥9 小时的情况，HRs（95%CI）分别为 2.16（1.03-4.51）、2.36（1.07-5.20）、2.41（1.11-5.20）和 3.37（1.05-10.81）。
夜间睡眠时间为 7-8 小时，且无日间小睡或日间小睡时间少于 1 小时的个体发生中风的风险较低；夜间睡眠时间≥9 小时且日间小睡≥1 小时，以及夜间睡眠时间<7 小时且日间小睡>1 小时与中风风险较高相关。临床试验注册：http://www.chictr.org。
ChiCTR-ECH-1200272，ChiCTR-ECH-12002938。
