Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Sweden (O.E.T., K.M., S.C.L.).
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (S.C.L.).
Stroke. 2020 Nov;51(11):3279-3285. doi: 10.1161/STROKEAHA.120.029902. Epub 2020 Sep 8.
Studies of sleep duration in relation to specific types of stroke are scarce. Moreover, the results are inconclusive and causality remains unclear. Our objective was to investigate whether sleep duration is associated with risk of stroke and its types using observational and Mendelian randomization designs.
The prospective study included 79 881 women and men (45-79 years of age) who were followed up for incident stroke or death over a mean follow-up of 14.6 years (1 164 646 person-years) through linkage to Swedish Registers. For the Mendelian randomization study, single-nucleotide polymorphisms associated with sleep duration were identified from a genome-wide association study. Summarized data for genetic associations with stroke were obtained from publicly available data of the MEGASTROKE and the International Stroke Genetics Consortia.
Compared with normal sleep duration, long sleep (≥9 hours per day) was associated with increased risk of total and ischemic stroke (hazard ratios [95% CI], 1.12 [1.03-1.22] and 1.14 [1.03-1.24], respectively), whereas short sleep (<7 h/d) was linked to higher risk of intracerebral hemorrhage (hazard ratio [95% CI], 1.21 [1.03-1.41]). The 2-sample Mendelian randomization analysis supported no causal association of short or long sleep duration with ischemic stroke as a whole.
In a prospective study, long sleep duration was associated with increased risk of total and ischemic stroke, whereas short sleep was linked to increased risk of intracerebral hemorrhage. However, the Mendelian randomization analysis did not show a significant detrimental effect of short or long sleep duration on the risk of total stroke or stroke types.
关于睡眠时间与特定类型中风之间关系的研究很少。此外，研究结果尚无定论，因果关系仍不清楚。我们的目的是使用观察性和孟德尔随机化设计来研究睡眠时间与中风风险及其类型之间的关系。
这项前瞻性研究纳入了 79881 名年龄在 45-79 岁的男女参与者，通过与瑞典登记处的链接，在平均 14.6 年（1164646人年）的随访期间，观察中风或死亡的发生。对于孟德尔随机化研究，从全基因组关联研究中确定与睡眠时间相关的单核苷酸多态性。从公开的 MEGASTROKE 和国际中风遗传学联合会的中风遗传关联汇总数据中获取与中风相关的遗传关联汇总数据。
与正常睡眠时间相比，长睡眠时间（≥9 小时/天）与总中风和缺血性中风风险增加相关（风险比[95%置信区间]分别为 1.12[1.03-1.22]和 1.14[1.03-1.24]），而短睡眠时间（<7 小时/天）与颅内出血风险增加相关（风险比[95%置信区间]为 1.21[1.03-1.41]）。两样本孟德尔随机化分析支持短或长睡眠时间与整体缺血性中风之间没有因果关联。
在一项前瞻性研究中，长睡眠时间与总中风和缺血性中风风险增加相关，而短睡眠时间与颅内出血风险增加相关。然而，孟德尔随机化分析并未显示短或长睡眠时间对总中风或中风类型风险的显著不利影响。
