Long Sleep Duration and Stroke—Highly Linked, Poorly Understood

Cai, Congjie; Atanasov, Strahil

doi:10.3390/neurolint15030048

Cited by 7 publications

(4 citation statements)

References 118 publications

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“…Diabetes is a major risk factor for stroke, and AF is a common cause of embolic stroke, making the issue of sleep duration a particular concern among diabetics. Prolonged sleep duration is associated with an increased incidence of diabetes and AF, potentially due to elevated levels of inflammation, arterial stiffness, and blood pressure variability [ 28 ]. Inflammation plays a key role in atherosclerosis and cardiovascular diseases, such as stroke.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Johansson et al involving 1,908 Finnish adults aged 41–74 years found that those sleeping more than 9 h had significantly higher blood pressure variability than those who slept for 7 h [ 33 ]. These findings highlight the importance of prolonged sleep duration as both a strong marker of stroke and a reliable risk factor, and suggest that it be emphasized in future risk classification and stroke prevention assessments [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Increased susceptibility to new-onset atrial fibrillation in diabetic women with poor sleep behaviour traits: findings from the prospective cohort study in the UK Biobank

Chen,

Liu,

Yan

et al. 2024

Diabetol Metab Syndr

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Background Diabetic individuals often encounter various sleep-related challenges. Although the association between sleep duration and atrial fibrillation (AF) have been explored, the association of other sleep traits with the incidence of AF remains unclear. A comprehensive understanding of these traits is essential for a more accurate assessment of sleep conditions in patients with diabetes and the development of novel AF prevention strategies. Methods This study involved 23,785 patients with diabetes without any pre-existing cardiovascular disease, drawn from the UK Biobank. Sleep behaviour traits examined encompassed sleep duration, chronotype, insomnia, snoring and daytime sleepiness. Sleep duration was categorised into three groups: low (≤ 5 h), proper (6–8 h) and long (≥ 9 h). We assessed associations using multivariate Cox proportional risk regression models. Furthermore, four poor sleep behaviours were constructed to evaluate their impact on the risk of new-onset AF. Results Over a mean follow-up period of 166 months, 2221 (9.3%) new cases of AF were identified. Short (hazard ratio (HR), 1.28; 95% confidence interval (CI) 1.10–1.50) and long sleep durations (HR 1.16; 95% CI 1.03–1.32) consistently exhibited an elevated risk of AF compared to optimal sleep duration. Early chronotype, infrequent insomnia and daytime sleepiness were associated with 11% (HR 0.89; 95% CI 0.82–0.97), 15% (HR 0.85; 95% CI 0.77–0.95) and 12% (HR 0.88; 95% CI 0.81–0.96) reduced risk of new-onset AF, respectively. However, no significant association was found between snoring and the incidence of AF (HR 0.99; 95% CI 0.91–1.07). Conclusions In diabetic populations, sleep duration, chronotype, insomnia and daytime sleepiness are strongly associated with AF incidence. An optimal sleep duration of 6–8 h presents the lowest AF risk compared to short or long sleep duration. Additionally, poor sleep patterns present a greater risk of new-onset AF in women than in men.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Increased susceptibility to new-onset atrial fibrillation in diabetic women with poor sleep behaviour traits: findings from the prospective cohort study in the UK Biobank

Chen,

Liu,

Yan

et al. 2024

Diabetol Metab Syndr

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“…According to a review by Grandner M.A. et al, the factors of fatigue, sleep fragmentation, immune function, lack of challenge, underlying disease (sleep apnea, heart disease), photope-riodic abnormalities, and depression could explain the association between long sleep patterns and mortality [40]. However, Patel S.R.…”

Section: Discussionmentioning

confidence: 99%

The U-Shaped Association between Sleep Duration, All-Cause Mortality and Cardiovascular Risk in a Hispanic/Latino Clinically Based Cohort

Henríquez-Beltrán,

Dreyse,

Jorquera

et al. 2023

JCM

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Sleep is essential for life, and inappropriate sleep duration patterns may lead to chronic consequences regarding human health. Several studies have confirmed the presence of a U-shaped association between sleep duration and mortality. Moreover, many consequences related to cardiometabolic aspects have been suggested in patients with abnormal sleep durations. In this study, we analyzed the associations between sleep duration, total sleep time (TST), the risk of all-cause mortality, and 10-year cardiovascular risk in a cohort of patients at a sleep medicine center in Santiago, Chile. We conducted a prospective cohort study of patients (SantOSA). A short TST was defined as ≤6 h, a normal TST as 6 to 9 h, and a long TST as ≥9 h. Adjusted hazard ratios (aHRs) for all-cause mortality were calculated. A cross-sectional analysis between TST and 10-year cardiovascular risk (calculated using the Framingham 2008 formula) was determined using logistic regression models. A total of 1385 subjects were included in the results (78% male; median age: 53, interquartile range (IQR): 42–64 years; median BMI: 29.5, IQR: 16.7–33.1). A total of 333 subjects (24%) reported short TSTs, 938 (67.7%) reported normal TSTs, and 114 (8.3%) reported long TSTs. In the fully adjusted model, the association remained significant for short (aHR: 2.51 (1.48–4.25); p-value = 0.01) and long TSTs (aHR: 3.97 (1.53–10.29); p-value = 0.04). Finally, a U-shaped association was found between short and long TSTs, with an increase in cardiovascular risk at 10 years. Compared with normal TSTs, short (≤6 h) and long (≥9 h) TSTs were significantly associated with all-cause mortality and increased 10-year cardiovascular risk.

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“…The association between long sleep and stroke is independent of confounders, has a dose–response relationship, and is specific for stroke. 47 …”

Section: Nonrespiratory Sleep Disorders As a Risk Factor For Strokementioning

confidence: 99%

Sleep disorders as both risk factors for, and a consequence of, stroke: A narrative review

Mayer-Suess,

Ibrahim,

Moelgg

et al. 2023

International Journal of Stroke

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Background and purpose Sleep disorders are increasingly implicated as risk factors for stroke, as well as a determinant of stroke outcome. They can also occur secondary to the stroke itself. In this review we describe the variety of different sleep disorders associated with stroke, and analyze their effect on stroke risk and outcome. Methods A search term-based literature review (“sleep”, “insomnia”, “narcolepsy”, “restless legs syndrome”, “periodic limb movements during sleep”, “excessive daytime sleepiness” AND “stroke” OR “cerebrovascular” in PubMed; “stroke” and “sleep” in ClinicalTrials.gov) was performed. English articles from 1990 to March 2023 were considered. Results Increasing evidence suggests that sleep disorders are risk factors for stroke. In addition, sleep disturbance has been reported in half of all stroke sufferers; specifically an increase in not only sleep-related breathing disorders, but also periodic limb movements during sleep, narcolepsy, REM sleep behavior disorder, insomnia, sleep duration- and circadian rhythm sleep-wake disorders. Post-stroke sleep disturbance has been associated with worse outcome. Conclusion Sleep disorders are risk factors for stroke and associated with worse stroke outcome. They are also a common consequence of stroke. Recent guidelines suggest screening for sleep disorders after stroke. It is possible that treatment of sleep disorders could both reduce stroke risk, and improve stroke outcome, although further data from clinical trials is required.

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Long Sleep Duration and Stroke—Highly Linked, Poorly Understood

Cited by 7 publications

References 118 publications

Increased susceptibility to new-onset atrial fibrillation in diabetic women with poor sleep behaviour traits: findings from the prospective cohort study in the UK Biobank

Increased susceptibility to new-onset atrial fibrillation in diabetic women with poor sleep behaviour traits: findings from the prospective cohort study in the UK Biobank

The U-Shaped Association between Sleep Duration, All-Cause Mortality and Cardiovascular Risk in a Hispanic/Latino Clinically Based Cohort

Sleep disorders as both risk factors for, and a consequence of, stroke: A narrative review

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