Association between sleep behaviors and stroke in Southwest China: a prospective cohort study

BACKGROUND: Sleep can function as a potential modifiable risk factor in the control and prevention of stroke. Geography significantly influences sleep patterns. The association of sleep with stroke in population of Southwest China has not so far been investigated. METHODS: A total of 55,001 residents aged from 30 to 79 years in Southwest China were included in this study, obtaining their complete information of baseline survey and follow-up in China Kadoorie Biobank (CKB). Sleep-evaluating score was constructed on the basis of short/long sleep duration, insomnia, and snoring. The multivariate Cox proportional hazards regression was used to analyze the association between sleep behaviors and stroke. RESULTS: During 11.15 years of follow-up, 3410 stroke cases (572.78 cases/100,000 person-years) were documented. There exists no association of sleep-evaluating score with the risk of stroke in the total population. Male-predisposing association between sleep-evaluating score and risk of stroke was observed (for total stroke, HR = 1.52, 95% CI: 1.03-2.23; for hemorrhagic stroke, HR = 2.31, 95% CI: 1.22-4.34), with anisotropism in male residents with overweight and obesity (HR = 1.93, 95% CI: 1.03-3.63), and those without hypertension (HR = 1.76, 95% CI: 1.01-3.07) in the baseline survey. CONCLUSIONS: There exists the male-predisposing association between sleep-evaluating score and the risk of stroke in Southwest China. Improving sleep is required for reducing the risk of stroke.