Association of Sleep Duration with Stroke in Diabetic Patients: Analysis of the National Health Interview Survey

Background: Habitual sleep duration is increasingly being recognized as an important risk factor for stroke. We sought to describe the association between sleep duration and stroke in a cohort of individuals with diabetes. Methods: Data from the National Health Interview Survey for the years 2004-2013 were used. Only those answering yes to the question Have you EVER been told by a doctor or other health professional that you have diabetes or sugar diabetes? were included in the analysis. Sleep duration was categorized as short (<= 6 hours), normal (7-8 hours), or long (>= 9 hours). Self-reported diagnosis of stroke was the main outcome of interest. Findings: A total number of 26,364 self-reported diabetic individuals provided data for analysis. Stroke was reported in 9.1% of short sleepers, 16.1% of long sleepers, and 8.3% of normative sleepers (P < .05). In the unadjusted model, short and long sleepers had an increased odds of stroke compared to normal sleepers (odds ratio [OR] = 1.12, 95% confidence interval [CI]: 1.02-1.23, P = .01; and OR = 2.18, 95% CI: 1.96-2.42, P = .01; respectively), but the association between short sleep and stroke became nonsignificant after multivariate adjustment (OR = 1.15, 95% CI:.95-1.40, P = .16) except in white participants. The association between long sleep duration and stroke persisted (OR = 1.46, 95% CI: 1.16-1.84, P = .01), especially in males (OR = 1.62, 95% CI: 1.14-2.28) and in white participants (OR = 1.97, 95% CI: 1.47-2.65). Conclusion: In diabetic patients, abnormal sleep duration was associated with increased risk of stroke, and this association varied among different sex and ethnic groups.