Background
Habitual sleep duration is increasingly being recognized as an important risk factor
for stroke. We sought to describe the association between sleep duration and stroke
in a cohort of individuals with diabetes.
Methods
Data from the National Health Interview Survey for the years 2004-2013 were used.
Only those answering “yes” to the question “Have you EVER been told by a doctor or
other health professional that you have diabetes or sugar diabetes?” were included
in the analysis. Sleep duration was categorized as short (≤6 hours), normal (7-8 hours),
or long (≥9 hours). Self-reported diagnosis of stroke was the main outcome of interest.
Findings
A total number of 26,364 self-reported diabetic individuals provided data for analysis.
Stroke was reported in 9.1% of short sleepers, 16.1% of long sleepers, and 8.3% of
normative sleepers (P < .05). In the unadjusted model, short and long sleepers had an increased odds of
stroke compared to normal sleepers (odds ratio [OR] = 1.12, 95% confidence interval
[CI]: 1.02-1.23, P = .01; and OR = 2.18, 95% CI: 1.96-2.42, P = .01; respectively), but the association between short sleep and stroke became nonsignificant
after multivariate adjustment (OR = 1.15, 95% CI: .95-1.40, P = .16) except in white participants. The association between long sleep duration
and stroke persisted (OR = 1.46, 95% CI: 1.16-1.84, P = .01), especially in males (OR = 1.62, 95% CI: 1.14-2.28) and in white participants
(OR = 1.97, 95% CI: 1.47-2.65).
Conclusion
In diabetic patients, abnormal sleep duration was associated with increased risk of
stroke, and this association varied among different sex and ethnic groups.
Key Words
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Article info
Publication history
Published online: December 28, 2015
Accepted:
November 22,
2015
Received in revised form:
November 12,
2015
Received:
August 18,
2015
Footnotes
Grant support: This research was supported by American Heart Association Scientist Development Grant (15SDG23250005) to P.S.D. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Statement of financial disclosure: This was not an industry-supported study. S.R. Pandi-Perumal is a stockholder and the President and Chief Executive Officer of Somnogen Canada Inc., a Canadian Corporation. He declares that he has no competing interests that might be perceived to influence the content of this article. All remaining authors report no conflicts of interest in this work.
Human participant protection: No protocol or institutional review board approval was needed for this study as the data were collected anonymously from a public health surveillance system in which adults voluntarily consented to telephone interviews.
Authors' contributions: Concept and design of the experiments: O.A.A. and L.I.A. Data collection: O.A.A. and L.I.A. Literature search: O.A.A., L.I.A., P.S.D., and S.R.P. Analysis of the data: O.A.A., L.I.A., and N.I.O. Interpretation of the data: O.A.A., N.I.O., and S.R.P. Writing of the manuscript: O.A.A., N.I.O., L.I.A., P.S.D., and S.R.P. All authors approved the final version of the manuscript prior to the submission.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.023
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
