OBJECTIVE@#To explore the relationship between
sleep habits (
sleep duration,
sleep efficiency,
sleep onset timing) and
ischemic stroke, and whether there is an interaction between
sleep habits and
ischemic stroke susceptibility
gene loci.@*
METHODS@#A
questionnaire survey,
physical examination,
blood biochemical testing and genotyping were conducted among rural residents in
Beijing, and the
gene loci of
ischemic stroke suggested by previous
genome-wide association studies (GWAS) were screened. Multivariable generalized
linear model was used to analyze the correlation between
sleep habits,
sleep-
gene interaction and
ischemic stroke.@*RESULTS@#A total of 4 648 subjects with an average age of (58.5±8.7) years were enrolled, including 1 316
patients with
ischemic stroke. Compared with non-
stroke patients,
stroke patients with
sleep duration ≥9 hours,
sleep efficiency < 80%, and
sleep onset timing earlier than 2200 accounted for a higher proportion (P < 0.05). There was no significant
association between
sleep duration and
risk of
ischemic stroke (OR=1.04, 95%CI 0.99-1.10, P=0.085).
Sleep efficiency was inversely associated with the
risk of
ischemic stroke (OR=0.18, 95%CI 0.06-0.53, P=0.002). The
risk of
ischemic stroke in the subjects with
sleep efficiency < 80% was 1.47-fold (95%CI 1.03-2.10, P=0.033) of that in the subjects with
sleep efficiency ≥80%.
Falling asleep earlier than 2200 was associated with 1.26 times greater
risk of
stroke than
falling asleep between 2200 and 2259 (95%CI 1.04-1.52, P=0.017). Multifactorial
adjustment model showed that rs579459 on ABO
gene had an interaction with
sleep time (P for interaction =0.040). When there were two T
alleles for rs579459 on the ABO
gene, those
who fell asleep before 2200 had 1.56 times (95%CI 1.20-2.04, P=0.001) the
risk of
stroke compared with those
who fell asleep between 2200 and 2259, and there was no significant difference when the number of pathogenic
alleles was 0 or 1. In the model adjusted only for
gender, age and
family structure,
sleep duration and the number of T
allele rs2634074 on PITX2
gene had an interaction with
ischemic stroke (P for interaction=0.033).@*CONCLUSION@#Decreased
sleep efficiency is associated with increased
risk of
ischemic stroke, and
falling asleep earlier than 2200 is associated with higher
risk of
ischemic stroke.
Sleep onset timing interacted with rs579459 in ABO
gene and the
risk of
ischemic stroke.
Sleep duration and PITX2 rs2634074 may have a potential interaction with
ischemic stroke risk.