The association between sleep duration, napping, and stroke stratified by self-health status among Chinese people over 6
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
The association between sleep duration, napping, and stroke stratified by self-health status among Chinese people over 65 years old from the China health and retirement longitudinal study Wei Li 1 & Anthony Kondracki 1 & Prem Gautam 1 & Abir Rahman 1 & Sandra Kiplagat 1 & Houqin Liu 2 & Wenjie Sun 1 Received: 2 June 2020 / Revised: 30 September 2020 / Accepted: 5 October 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose Stroke is a major cause of death in China. This study aimed to investigate the association between sleep duration (nighttime sleep and daytime napping) and stroke in elderly Chinese individuals with self-reported health status. Methods A total of 4785 Chinese adults over 65 years from the 2011 China Health and Retirement Longitudinal Study (CHARLS) were included. Binary logistic regression was used to estimate odds ratios and 95% confidence intervals of the association between sleep duration and stroke stratified by self-reported health status. Results A significant association between short sleep duration (< 7 h per day) and the risk of stroke (aOR = 2.05; 95% CI 1.31– 3.19), after controlling for sociodemographic characteristics, lifestyle factors, health status, and comorbidities. There was no significant association between short and long sleep duration and stroke in the individuals who reported good general health status. However, in individuals who reported poor health status, short sleep duration (aOR = 2.11; 95% CI 1.30–3.44) and long sleep duration (aOR = 1.86; 95% CI 1.08–3.21) were significantly associated with increased risk of stroke, compared with normal sleep duration (7–8 h per day). Disability was significantly associated with stroke in both self-reported good and poor health groups. Rural residence was significantly associated with a lower risk of stroke among individuals who reported poor health status. Conclusions Both short and long sleep duration were significantly associated with stroke among individuals who reported poor health. Stroke prevention should be focused on elderly individuals who believe that they have health problems. Keywords Stroke . Sleep duration . Nap . Health status . Aging Chinese
Introduction Stroke accounts for a high rate of mortality around the world and is a primary cause of death in China [1]. During 2017, stroke has dominated as the leading cause of years of life lost (YLLs), notwithstanding a 33.5% decrease in agestandardized mortality since 1990 [2]. This burden is extremely remarkable among the aging Chinese population with a * Houqin Liu [email protected] * Wenjie Sun [email protected] 1
Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th st, Miami, FL 33199, USA
2
Department of Geriatrics, The Second People’s Hospital of Lianyungang, No. 41 Hailiandong Road, Lianyungang 222006, Jiangsu, China
high prevalence of risk factors such as high blood pressure, diabetes, age, family history and genetics, overweight, and obesity [3]
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