Cardiovascular
Insufficient Sleep Elevates Stroke Risk: a meta-analysis János Tibor Fekete* Janos Tibor Fekete Zoltan Ungvari Mónika Fekete Andrea Lehoczki Gyöngyi Munkácsy Virág Zábó György Purebl Péter Varga Anna Ungvari Balázs Győrffy
Background: The relationship between abnormal sleep duration and stroke outcomes remains controversial. This meta-analysis aims to quantify the impact of both short and long sleep durations on stroke incidence and mortality.
Methods: A comprehensive search of PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar was conducted up to November 1, 2024, to identify cohort studies examining the relationship between sleep duration and stroke outcomes. The meta-analysis was carried out using MetaAnalysisOnline.com.
Results: A total of 43 studies (35 on stroke incidence, 8 on stroke mortality) were included in the analysis. Short sleep duration (≤5–6 hours) was associated with a 29% increased risk of stroke incidence (HR: 1.29, 95% CI: 1.19–1.40, p<0.01) and a modest 12% increase in stroke mortality (HR: 1.12, 95% CI: 1.01–1.25, p=0.03). Long sleep duration (>8–9 hours) showed stronger associations, with a 46% increase in stroke incidence (HR: 1.46, 95% CI: 1.33–1.60, p<0.01) and a 45% increase in stroke mortality (HR: 1.45, 95% CI: 1.31–1.60, p<0.01). Significant heterogeneity was observed in studies on stroke incidence (I² = 74–75%), whereas studies on stroke mortality displayed moderate to low heterogeneity (I² = 35–40%).
Conclusions: This meta-analysis highlights a U-shaped association between sleep duration and stroke risk, with both short and long sleep durations linked to higher stroke incidence and mortality.