Daytime Sleepiness and Risk of Stroke and Vascular Disease
Circulation: Cardiovascular Quality and Outcomes, 08/03/2012
Boden–Albala B et al. – Daytime sleepiness is an independent risk factor for stroke and other vascular events. These findings suggest the importance of screening for sleep problems at the primary care level.Methods
- As part of the Northern Manhattan Study, the Epworth Sleepiness Scale was collected during the 2004 annual follow–up. Daytime sleepiness was trichotomized using previously reported cut points of no dozing, some dozing, and significant dozing. Subjects were followed annually for a mean of 5.1 years.
- Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for stroke, myocardial infarction, and death outcomes.
- The authors obtained the Epworth Sleepiness Scale on 2088 community residents. The mean age was 73.5±9.3 years; 64% were women; 17% were white, 20% black, 60% Hispanic, and 3% were other.
- Over 44% of the cohort reported no daytime dozing, 47% some dozing, and 9% significant daytime dozing.
- Compared with those reporting no daytime dozing, individuals reporting significant dozing had an increased risk of ischemic stroke (hazard ratio, 2.74 [95% confidence interval, 1.38–5.43]), all stroke (3.00 [1.57–5.73]), the combination of ischemic stroke, myocardial infarction, and vascular death (2.38 [1.50–3.78]), and all vascular events (2.48 [1.57–3.91]), after adjusting for medical comorbidities.