睡眠时间、午睡和睡眠质量与卒中事件：东风-同济队列研究。

Sleep duration, midday napping, and sleep quality and incident stroke: The Dongfeng-Tongji cohort.

机构信息

From the Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) (L.Z., K.Y., L.Y., H.W., Y.X., G.Q., X.L., Y.Y., Y.B., M.H., T.W., X.Z.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan; Department of Cardiovascular Diseases (X.L., H.Y.), Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan; and Department of Epidemiology and Biostatistics (C.W.), College of Public Health, Zhengzhou University, China.

出版信息

Neurology. 2020 Jan 28;94(4):e345-e356. doi: 10.1212/WNL.0000000000008739. Epub 2019 Dec 11.

DOI:10.1212/WNL.0000000000008739

PMID:31827003

Abstract

OBJECTIVE

To investigate the associations of sleep duration, midday napping, sleep quality, and change in sleep duration with risk of incident stroke and stroke subtypes.

METHODS

Among 31,750 participants aged 61.7 years on average at baseline from the Dongfeng-Tongji cohort, we used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident stroke.

RESULTS

Compared with sleeping 7 to <8 hours/night, those reporting longer sleep duration (≥9 hours/night) had a greater risk of total stroke (hazard ratio [HR] 1.23; 95% confidence interval [CI] 1.07-1.41), while shorter sleep (<6 hours/night) had no significant effect on stroke risk. The HR (95% CI) of total stroke was 1.25 (1.03-1.53) for midday napping >90 minutes vs 1-30 minutes. The results were similar for ischemic stroke. Compared with good sleep quality, those with poor sleep quality showed a 29%, 28%, and 56% higher risk of total, ischemic, and hemorrhagic stroke, respectively. Moreover, we observed significant joint effects of sleeping ≥9 hours/night and midday napping >90 minutes (HR 1.85; 95% CI 1.28-2.66), and sleeping ≥9 hours/night and poor sleep quality (HR 1.82; 95% CI 1.33-2.48) on risk of total stroke. Furthermore, compared with persistently sleeping 7-9 hours/night, those who persistently slept ≥9 hours/night or switched from 7 to 9 hours to ≥9 hours/night had a higher risk of total stroke.

CONCLUSIONS

Long sleep duration, long midday napping, and poor sleep quality were independently and jointly associated with higher risks of incident stroke. Persistently long sleep duration or switch from average to long sleep duration increased the risk of stroke.

摘要

目的

研究睡眠时间、午睡时长、睡眠质量以及睡眠时间变化与新发卒中及卒中亚型风险的相关性。

方法

在来自东风-同济队列的 31750 名平均年龄为 61.7 岁的参与者中，我们使用 Cox 回归模型来估计新发卒中的风险比（HR）和 95%置信区间（CI）。

结果

与每晚睡眠 7-<8 小时相比，报告睡眠时间较长（≥9 小时/晚）的人总卒中风险更高（风险比[HR] 1.23；95%CI 1.07-1.41），而睡眠时间较短（<6 小时/晚）对卒中风险没有显著影响。午睡时长>90 分钟（HR 95%CI 1.25[1.03-1.53]）与午睡时长 1-30 分钟相比，总卒中的 HR（95%CI）更高。缺血性卒中的结果类似。与睡眠质量良好者相比，睡眠质量差者发生总卒中、缺血性卒中和出血性卒中的风险分别增加 29%、28%和 56%。此外，我们观察到睡眠时间≥9 小时/晚和午睡时长>90 分钟（HR 1.85；95%CI 1.28-2.66）以及睡眠时间≥9 小时/晚和睡眠质量差（HR 1.82；95%CI 1.33-2.48）对总卒中风险的显著联合作用。此外，与持续睡眠 7-9 小时/晚相比，持续睡眠≥9 小时/晚或从 7 小时切换至 9 小时/晚至≥9 小时/晚的人总卒中风险更高。