title: Association of Sleep Duration with Stroke in Diabetic Patients: Analysis of the National Health Interview Survey.
abstract: 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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  In diabetic patients, abnormal sleep duration was associated with increased risk of stroke, and this association varied among different sex and ethnic groups.
authors.affiliation: Department of Internal Medicine, Queens Hospital Center, Icahn School of Medicine at Mount Sinai, Jamaica, New York; CUNY School of Public Health at Brooklyn College, New York, New York. Electronic address: oluwaseun.akinseye@mssm.edu.
authors.forename: Oluwaseun A
authors.initials: OA
authors.lastname: Akinseye
authors.affiliation: Department of Population Health, Center for Behavioral Healthful Change, NYU School of Medicine, New York, New York.
authors.forename: Nwakile I
authors.initials: NI
authors.lastname: Ojike
authors.affiliation: CUNY School of Public Health at Brooklyn College, New York, New York.
authors.forename: Leah I
authors.initials: LI
authors.lastname: Akinseye
authors.affiliation: The Knight Cardiovascular Institute, Departments of Medicine, Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon; Centre for Cardiovascular Biology and Disease, Institute for Stem Cell Biology and Regenerative Medicine (inStem), Bangalore, India.
authors.forename: Perundurai S
authors.initials: PS
authors.lastname: Dhandapany
authors.affiliation: Department of Health & Nutrition Sciences, Somnogen Canada Inc., Toronto, Ontario, Canada.
authors.forename: Seithikurippu R
authors.initials: SR
authors.lastname: Pandi-Perumal
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D057566:Self Report; D017678:Sex Distribution; D012890:Sleep / Q000502:physiology*; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology*; D055815:Young Adult
keywords: Sleep duration; diabetes; long sleep duration; short sleep duration; stroke