October 17, 2018
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Sleep duration related to stroke risk, varies by race

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Black men who sleep for a short amount of time had a decreased risk for incident stroke, and white men with longer sleep duration had an increased risk for incident stroke, according to a study published in Neurology.

“These results suggest that short and long sleep duration may have different consequences for people depending on race and sex,” Virginia J. Howard, PhD, professor of epidemiology at the University of Alabama at Birmingham School of Public Health, said in a press release. “More research is needed to determine the mechanisms behind these relationships. In the meantime, this emphasizes how important it is to better monitor and control cardiovascular risk factors in middle-aged to older people who have long sleep periods.”

Megan E. Petrov, PhD, assistant professor at Arizona State University College of Nursing and Health Innovation in Phoenix, and colleagues analyzed data from 16,733 patients (mean age, 64 years; 42% men; 37% black) from the REGARDS study who were free from stroke and obstructive sleep apnea. Patients completed an ancillary sleep module with questions on habitual sleep duration. A telephone interview was conducted every 6 months to collect information on suspected stroke events.

At baseline, 10.4% of patients reported receiving less than 6 hours of sleep and 6.8% reported sleeping at least 9 hours.

During a median follow-up of 6.1 years, 460 stroke events occurred, with 172 of them occurring in black patients.

There were significant interactions between sleep duration and race-sex groups (P = .0023) and sleep duration and race (P = .018) that were linked to incident stroke.

Black patients with short sleep duration had a decreased risk for stroke after adjusting for stroke risk factors (HR = 0.49; 95% CI, 0.28-0.85). This was most pronounced in black men (HR = 0.21; 95% CI, 0.07-0.69).

The risk for stroke was elevated in white men with long sleep duration after adjusting for stroke risk factors (HR = 1.71; 95% CI, 1.06-2.76).

“The underlying mechanisms that may explain the race and race by sex differences we found in the association between sleep duration and incident stroke are not well-understood,” Petrov and colleagues wrote. “The alleged reduction in associated risk of incident stroke among black adults with short sleep duration, particularly black men, is perplexing, and conflicts with other studies examining race by sleep interactions on cardiometabolic risk factors.” – by Darlene Dobkowski

Disclosures: Howard and Petrov report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.