ArticleScientific reports2020
Interactive effect of sleep duration and sleep quality on risk of stroke: An 8-year follow-up study in China.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Inadequate sleep increases stroke risk: evidence from a comprehensive meta-analysis of incidence and mortality.GeroScience · 2025Pooled it
- The effectiveness of exercise interventions in the improvement of sleep in older adult people: a meta-analysis.Frontiers in public health · 2025Pooled it
- Pooled incidence and case-fatality of acute stroke in Mainland China, Hong Kong, and Macao: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Sleep duration and risk of cardio-cerebrovascular disease: A dose-response meta-analysis of cohort studies comprising 3.8 million participants.Frontiers in cardiovascular medicine · 2022Pooled it
- The Effect of Group Spiritual Reminiscence on the Sleep Quality of Postmenopausal Women in Iran: A Clinical Trial Study.Journal of religion and health · 2026Trial
- Risk perception bias, lifestyle, and chronic disease risk in the middle-aged and older Chinese population: results of a national prospective longitudinal study.BMC public health · 2026Article
- Menopause-Related Changes in Sleep and the Associations with Cardiometabolic Health: A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Prestroke sleep and stroke: a narrative review.Sleep & breathing = Schlaf & Atmung · 2025Review
- Review
- Daily physical activity, coffee and energy drink consumption, and sleep patterns among Chinese elite professional esports athletes: a case study of Zhejiang Regans Gaming.Frontiers in public health · 2025Article
- Self-reported sleep duration and quality and cardiovascular diseases among middle-aged and older Chinese: A 7-year longitudinal cohort study.Journal of clinical hypertension (Greenwich, Conn.) · 2024Article
- Association of total sleep duration variability with risk of new stroke in the middle-aged and elderly Chinese population.BMC neurology · 2024Article
- Prevalence and determinants of depressive symptoms among community-dwelling older adults in China based on differences in living arrangements: a cross-sectional study.BMC geriatrics · 2023Article
- Long Sleep Duration and Stroke-Highly Linked, Poorly Understood.Neurology international · 2023Review
- Sleep Patterns and the Risk of Acute Stroke: Results From the INTERSTROKE International Case-Control Study.Neurology · 2023Article
- The independent and combined association of napping and night sleep duration with stroke in Chinese rural adults.Sleep & breathing = Schlaf & Atmung · 2023Article
- Association Between Sleep Duration and Stroke in Different Status of Metabolic Syndrome: A Cross-Sectional Study in Shanghai Adult Residents.Nature and science of sleep · 2023Article
- Pre-Diagnosis Sleep Status and Survival after a Diagnosis of Ovarian Cancer: A Prospective Cohort Study.Journal of clinical medicine · 2022Article
- Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship.Current neurology and neuroscience reports · 2022Review
- Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inappropriate sleep duration and poor sleep quality are associated with risk of stroke, but their interactive effect on stroke is unknown. We explored the interactive effect of sleep quality and duration on stroke risk. A prospective cohort study was conducted with 41,786 adults. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sleep duration was measured by average hours of sleep per night. Cox regression models were used to calculate the association of sleep duration and quality with stroke. The delta method and a non-conditional logistic regression model were used and the relative excess risk due to interaction (RERI), the attributable proportion (AP), and the synergy index (S) were calculated. Compared with sleep duration 6-8 h/day, the risk ratio of stroke was 1.63 (1.23-2.11) times for sleep duration <6 h/day and 1.40 (1.08-1.75) times for >8 h/day. The stroke risk ratio was 2.37 (1.52-3.41) times in subjects with poor sleep quality compared with those with good sleep quality. Women who slept <6 h/day had higher stroke risk than men who slept <6 h/day. Men who slept >8 h/day had higher stroke risk than women who slept >8 h/day. Men with poor sleep quality had higher stroke risk than women with poor sleep quality. Stroke was associated with short/long sleep duration and poor sleep quality in subjects aged >46 years, compared with those aged 18-45 years. Stroke occurred more frequently in subjects with poor sleep quality combined with short sleep duration (odds ratio: 6.75; 95% confidence interval (CI): 2.45-14.12). RERI, AP, and S values (and their 95% CIs) were 5.54 (3.75-8.12), 0.72 (0.56-0.80), and 5.69 (4.23-9.90) for the poor sleep quality interact with short sleep duration. In persons with poor sleep quality accompanied by long sleep duration, RERI, AP, and S (95% CI) were 1.12 (1.01-1.27), 0.35 (0.26-0.51), and 2.05 (1.57-2.96), respectively. Subjective sleep disturbances are related with risk of stroke in Chinese adults. There are additive interactions between short/long sleep duration and poor sleep quality that affect risk of stroke.
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Registered trials
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