Liu Xingyue, Zhang Juhua, Peng Shuzhi, Pei Mengyun, Dai Chunying, Wang Tingting, Zhang Peng
Graduate School, Shanghai University of Medicine and Health Sciences, Shanghai, China.
Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Neurosci. 2022 Aug 11;16:960497. doi: 10.3389/fnins.2022.960497. eCollection 2022.
Sleep disturbance is commonly reported by menopausal women. Stroke risk and poor stroke outcomes in women have usually been attributed to menopause. This study aimed to investigate the mediating effect of sleep duration on relationship between menopause and risk of stroke in natural menopause women.
A cross-sectional study was performed, and participants were recruited through a multistage, stratified, probability proportional to size sampling method in this research. The stroke risk was measured using the risk assessment form for high-risk stroke population. The average sleep duration was calculated by adding up night sleep and afternoon nap duration. Multivariate regression analysis was conducted to identify the association between menopause, sleep duration, and stroke risk. The direct and indirect effects of menopause on stroke risk were analyzed by using the sleep duration in a mediation framework.
Perimenopause, menopause, average sleep duration, and night sleep duration were significantly associated with stroke risk ( < 0.001), after adjusting for covariates. Perimenopause and menopause were significantly related to average sleep duration ( < 0.001) and night sleep duration ( < 0.001). The average sleep duration (ab = 0.016, 95% CI: 0.003, 0.030; ab = -0.048, 95% CI: -0.070, -0.027) partially mediated the relationship between menopause and stroke risk. And night sleep duration (ab = 0.024, 95% CI: 0.009, 0.040; ab = -0.054, 95% CI: -0.077, -0.033) played a major mediating role, in which night sleep duration of ≤5 h mediated the link between both perimenopause (ab = 0.707, 95% CI: 0.392, 1.021) and menopause (ab = -0.787, 95% CI: -1.096, -0.478) and stroke risk; both night sleep duration of >8-9 h (ab = 0.079, 95% CI: 0.010, 0.193) and >9 h (ab = 0.379, 95% CI: 0.086, 0.712) had mediating effects on perimenopause and stroke risk.
A significant relationship between menopause and stroke risk factors among natural menopausal status was found in this study. The average sleep duration, especially night sleep duration, partially mediated the association between menopause and stroke risk, which is a novel insight to the progression of stroke risk in Women. Suitable prevention methods and interventions for sleep in menopausal women may reduce the risk of stroke.
绝经后女性经常出现睡眠障碍。女性中风风险及不良中风预后通常归因于绝经。本研究旨在探讨睡眠时间在自然绝经女性绝经与中风风险关系中的中介作用。
本研究采用横断面研究，通过多阶段、分层、规模比例概率抽样方法招募参与者。使用高危中风人群风险评估表测量中风风险。通过将夜间睡眠时间和午睡时间相加计算平均睡眠时间。进行多变量回归分析以确定绝经、睡眠时间与中风风险之间的关联。在中介框架中使用睡眠时间分析绝经对中风风险的直接和间接影响。
在调整协变量后，围绝经期、绝经、平均睡眠时间和夜间睡眠时间与中风风险显著相关（<0.001）。围绝经期和绝经与平均睡眠时间（<0.001）和夜间睡眠时间（<0.001）显著相关。平均睡眠时间（ab = 0.016，95% CI：0.003，0.030；ab = -0.048，95% CI：-0.070，-0.027）部分介导了绝经与中风风险之间的关系。夜间睡眠时间（ab = 0.024，95% CI：0.009，0.040；ab = -0.054，95% CI：-0.077，-0.033）起主要中介作用，其中夜间睡眠时间≤5小时介导了围绝经期（ab = 0.707，95% CI：0.392，1.021）和绝经（ab = -0.787，95% CI：-1.096，-0.478）与中风风险之间的联系；夜间睡眠时间>8 - 9小时（ab = 0.079，95% CI：0.010，0.193）和>9小时（ab = 0.379，95% CI：0.086，0.712）对围绝经期和中风风险均有中介作用。
本研究发现自然绝经状态下绝经与中风风险因素之间存在显著关系。平均睡眠时间，尤其是夜间睡眠时间，部分介导了绝经与中风风险之间的关联，这为女性中风风险进展提供了新见解。针对绝经后女性睡眠的合适预防方法和干预措施可能会降低中风风险。
