Sleep duration, midday napping and sleep quality and incident stroke: the Dongfeng-Tongji cohort

Objective: To investigate the associations of sleep duration, midday napping and sleep quality, and change in sleep duration with risk of incident stroke and stroke subtypes. Methods: Among 31750 participants aged 61.7 years on average at baseline from the Dongfeng-Tongji cohort, we used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident stroke. Results: Compared with sleeping 7-<8 h/night, those reporting longer sleep duration (≥9 h/night) had a greater risk of total stroke (HR, 1.23; 95% CI, 1.07-1.41), while shorter sleep (<6 h/night) had no significant effect on stroke risk. The HR (95% CI) of total stroke was 1.25 (1.03-1.53) for midday napping >90 min vs 1-30 min. The results were similar for ischemic stroke. Compared with good sleep quality, those with poor sleep quality showed a 29%, 28% and 56% higher risk of total, ischemic, and hemorrhagic stroke, respectively. Moreover, we observed significant joint effects of sle...