Sleep disturbance, stroke, and heart disease events: evidence from the Caerphilly cohort.
OBJECTIVE
To test the hypothesis that sleep disorders are relevant to the risk of ischaemic stroke and ischaemic heart disease events in older men.


METHODS
A cohort study.


METHODS
The Caerphilly cohort, a representative population sample of older men in South Wales, UK.


METHODS
1986 men aged 55-69 years completed a questionnaire on sleep patterns with help from their partners. This asked about symptoms of disturbed sleep: insomnia, snoring, restless legs, obstructive sleep apnoea, and about daytime sleepiness. During the following 10 years 107 men experienced an ischaemic stroke and 213 had an ischaemic heart disease event.


RESULTS
Up to one third of the men reported at least one symptom suggestive of sleep disturbance, and one third reported daytime sleepiness. Compared with men who reported no such symptoms, the adjusted relative odds of an ischaemic stroke were significantly increased in men with any sleep disturbance, the strongest association being with sleep apnoea (relative odds 1.97; 1.26 to 3.09). The association with daytime sleepiness was not significant for stroke. Relations with ischaemic heart disease events were all raised in men with symptoms of sleep disturbance, but none was significant, other than daytime sleepiness (relative odds: 1.41; 1.04 to 1.92). There were no significant relations with blood pressure.


CONCLUSIONS
The risk of an ischaemic stroke is increased in men whose sleep is frequently disturbed, and daytime sleepiness is associated with a significant increase in ischaemic heart disease events.
Elwood
Peter
P
MRC Unit, Llandough Hospital, Penarth CF64 2XW, UK. pelwood@doctors.org.uk
Hack
Melissa
M
Pickering
Janet
J
Hughes
Janie
J
Gallacher
John
J
D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014852:Wales / Q000453:epidemiology