Abstract DP360: Association of Daily Sleep Duration with Stroke among Patients with Different Hypertension Status

Introduction: Sleep deprivation is associated with the risk of stroke. The association between sleep duration and stroke among patients with different hypertension statuses is unclear. We aim to examine the association of sleep duration on weekdays and weekends with a history of stroke in patients with and without hypertension. Methods: A cross-sectional study using the 2017-2023 NHANES included adults with and without a history of stroke. The association of tertiles (T) of sleep durations on weekdays and weekends with a history of stroke was examined by multiple binary logistic regression analyses. Results: Of 17,846 participants ≥18 years old, the mean±SD age was 51±19 years, and 53% were female. Mean sleep durations on the weekdays, weekends, and whole week were 7.68±1.66, 8.30±1.77, and 7.99±1.53 hours, respectively. Mean sleep durations on the weekdays in T1, 2, and 3 were 6.12, 7.83, and 9.44 hours, and sleep duration on the weekends were 7.01, 8.85, and 10.56 hours, respectively. There were 854 patients (5.01%) ever had a stroke. Up to 73% of patients with stroke had hypertension, while 36% of non-stroke participants were hypertensive (P <0.0001). Compared to patients in T1 of weekday sleep durations, those with T2 had 28% lower odds of stroke, while those in T3 had 56% higher odds (OR T2 (95%CI) 0.72 (0.59, 0.87); OR T3 1.56 (1.33, 1.82)). Similarly, patients in T2 had 19% lower odds and those in T3 had 21% higher odds of stroke compared to patients in T1 (OR T2 (95%CI) 0.81 (0.68, 0.97); OR T3 1.21 (1.02, 1.42)). After adjusted for age, gender, race, ethnicity, level of education, body mass index, mean SBP and DBP, history of diabetes mellitus, and hyperlipidemia, patients in T2 of weekday sleep duration had 31% significantly lower odds of stroke only in patients with hypertension compared to patients in T1 (OR T2 (95%CI) 0.69 (0.52, 0.91); OR T3 1.26 (0.99, 1.59)). On the other hand, patients in T3 of weekend sleep durations had 53% significantly higher odds of stroke compared to patients in T1 only in non-hypertensive participants (OR T2 (95%CI) 1.16 (0.77, 1.76); OR T3 1.53 (1.02, 2.32)). Conclusions: While lack of sleep on the weekdays of <6.1 hours is associated with a higher risk of stroke in patients with hypertension, the risk is higher in patients without hypertension and longer sleep duration on the weekend of 10.6 hours. Underlying mechanism of this association and long-term outcomes require further studies.