TY - JOUR
T1 - Self-reported sleep duration in relation to incident stroke symptoms
T2 - Nuances by body mass and race from the REGARDS study
AU - Petrov, Megan
AU - Letter, Abraham J.
AU - Howard, Virginia J.
AU - Kleindorfer, Dawn
N1 - Funding Information:
Financial support: This research project is supported by a co-operative agreement (U01 NS041588) from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service. M.E.R.P. received training support from Agency for Healthcare Research and Quality (5 T32 HS013852-09) and National Institute on Minority Health and Health Disparities (3 P60 MD000502-08S1).
PY - 2014/2
Y1 - 2014/2
N2 - Background To determine, among employed persons with low risk for obstructive sleep apnea (OSA), if sleep duration is associated with incident stroke symptoms, independent of body mass index (BMI), and if sleep duration mediates racial differences in stroke symptoms. Methods In 2008, 5666 employed participants (US blacks and whites, ≥45 years) from the longitudinal and nationally representative Reasons for Geographic And Racial Differences in Stroke study self-reported their average sleep duration. Participants had no history of stroke, transient ischemic attack, or stroke symptoms and were at low risk for OSA. After the sleep assessment, self-reported stroke symptoms were collected at 6-month intervals, up to 3 years (M = 751 days). Interval-censored, parametric survival models were conducted to estimate hazard ratios predicting time from sleep duration measurement (<6, 6-6.9, 7-7.9 [reference], 8-8.9, ≥9 hours) to first stroke symptom. Adjusted models included demographics, stroke risk factors, psychological symptoms, health behaviors, and diet. Results During follow-up, 224 participants reported 1 or more stroke symptoms. In the unadjusted model, short sleep (<6 hours) significantly predicted increased risk of stroke symptoms but not in adjusted models. Stratification by BMI revealed a significant association between short sleep duration and stroke symptoms only for normal BMI persons in unadjusted (hazard ratio: 2.93, 95% confidence interval: 1.38-6.22) and fully adjusted models (hazard ratio: 4.19, 95% confidence interval: 1.62-10.84). The mediating effect of sleep duration on the relationship between race and stroke symptoms was borderline significant in normal weight participants. Conclusions Among middle-aged to older employed individuals of normal weight and low risk of OSA, self-reported short sleep duration is prospectively associated with increased risk of stroke symptoms.
AB - Background To determine, among employed persons with low risk for obstructive sleep apnea (OSA), if sleep duration is associated with incident stroke symptoms, independent of body mass index (BMI), and if sleep duration mediates racial differences in stroke symptoms. Methods In 2008, 5666 employed participants (US blacks and whites, ≥45 years) from the longitudinal and nationally representative Reasons for Geographic And Racial Differences in Stroke study self-reported their average sleep duration. Participants had no history of stroke, transient ischemic attack, or stroke symptoms and were at low risk for OSA. After the sleep assessment, self-reported stroke symptoms were collected at 6-month intervals, up to 3 years (M = 751 days). Interval-censored, parametric survival models were conducted to estimate hazard ratios predicting time from sleep duration measurement (<6, 6-6.9, 7-7.9 [reference], 8-8.9, ≥9 hours) to first stroke symptom. Adjusted models included demographics, stroke risk factors, psychological symptoms, health behaviors, and diet. Results During follow-up, 224 participants reported 1 or more stroke symptoms. In the unadjusted model, short sleep (<6 hours) significantly predicted increased risk of stroke symptoms but not in adjusted models. Stratification by BMI revealed a significant association between short sleep duration and stroke symptoms only for normal BMI persons in unadjusted (hazard ratio: 2.93, 95% confidence interval: 1.38-6.22) and fully adjusted models (hazard ratio: 4.19, 95% confidence interval: 1.62-10.84). The mediating effect of sleep duration on the relationship between race and stroke symptoms was borderline significant in normal weight participants. Conclusions Among middle-aged to older employed individuals of normal weight and low risk of OSA, self-reported short sleep duration is prospectively associated with increased risk of stroke symptoms.
KW - Self-reported sleep duration
KW - body mass index
KW - race
KW - stroke symptoms
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U2 - 10.1016/j.jstrokecerebrovasdis.2013.09.009
DO - 10.1016/j.jstrokecerebrovasdis.2013.09.009
M3 - Article
C2 - 24119626
AN - SCOPUS:84893390466
SN - 1052-3057
VL - 23
SP - e123-e132
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 2
ER -