Lindsey B De Lott1, Lynda D Lisabeth2, Brisa N Sanchez3, Lewis B Morgenstern2, Melinda A Smith1, Nelda M Garcia1, Ronald Chervin4, Devin L Brown5. 1. Stroke Program, The Cardiovascular Center - Stroke Program, 1500 E. Medical Center Drive - SPC#5855, Ann Arbor, MI 48109-5855, USA. 2. Stroke Program, The Cardiovascular Center - Stroke Program, 1500 E. Medical Center Drive - SPC#5855, Ann Arbor, MI 48109-5855, USA; Department of Epidemiology, 1014 SPH I, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA. 3. Department of Biostatistics, M4164 SPH II, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA. 4. Sleep Disorders Center, University of Michigan, 1500 East Medical Center Drive, Med Inn C728, Ann Arbor, MI, USA. 5. Stroke Program, The Cardiovascular Center - Stroke Program, 1500 E. Medical Center Drive - SPC#5855, Ann Arbor, MI 48109-5855, USA. Electronic address: devinb@umich.edu.
Abstract
BACKGROUND: The ethnic disparity in ischemic stroke between Mexican Americans (MAs) and non-Hispanic whites (NHWs) may be partly attributable to disparities in sleep and its disorders. We therefore assessed whether pre-stroke sleep apnea symptoms (SA risk) and pre-stroke sleep duration differed between MAs and NHWs. METHODS: MA and NHW ischemic stroke survivors in the Brain Attack Surveillance in Corpus Christi (BASIC) project reported sleep duration and SA symptoms on the validated Berlin questionnaire, both with respect to their pre-stroke baseline. Log binomial and linear regression models were used to test the unadjusted and adjusted (demographics and vascular risk factors) associations of high-risk Berlin scores and sleep duration with ethnicity. RESULTS: Among 862 subjects, 549 (63.7%) were MA and 514 (59.6%) had a high risk of pre-stroke SA. The MA and NHW subjects showed no ethnic difference, after adjustment for potential confounders, in pre-stroke SA risk (risk ratio (95% confidence interval (CI)): 1.06 (0.93, 1.20)) or in pre-stroke sleep duration (on average MAs slept 2.0 fewer minutes than NHWs, 95% CI: -18.8, 14.9 min). CONCLUSIONS: Pre-stroke SA symptoms are highly prevalent, but ethnic differences in SA risk and sleep duration appear unlikely to explain ethnic stroke disparities.
BACKGROUND: The ethnic disparity in ischemic stroke between Mexican Americans (MAs) and non-Hispanic whites (NHWs) may be partly attributable to disparities in sleep and its disorders. We therefore assessed whether pre-stroke sleep apnea symptoms (SA risk) and pre-stroke sleep duration differed between MAs and NHWs. METHODS: MA and NHW ischemic stroke survivors in the Brain Attack Surveillance in Corpus Christi (BASIC) project reported sleep duration and SA symptoms on the validated Berlin questionnaire, both with respect to their pre-stroke baseline. Log binomial and linear regression models were used to test the unadjusted and adjusted (demographics and vascular risk factors) associations of high-risk Berlin scores and sleep duration with ethnicity. RESULTS: Among 862 subjects, 549 (63.7%) were MA and 514 (59.6%) had a high risk of pre-stroke SA. The MA and NHW subjects showed no ethnic difference, after adjustment for potential confounders, in pre-stroke SA risk (risk ratio (95% confidence interval (CI)): 1.06 (0.93, 1.20)) or in pre-stroke sleep duration (on average MAs slept 2.0 fewer minutes than NHWs, 95% CI: -18.8, 14.9 min). CONCLUSIONS: Pre-stroke SA symptoms are highly prevalent, but ethnic differences in SA risk and sleep duration appear unlikely to explain ethnic stroke disparities.
Authors: H Klar Yaggi; John Concato; Walter N Kernan; Judith H Lichtman; Lawrence M Brass; Vahid Mohsenin Journal: N Engl J Med Date: 2005-11-10 Impact factor: 91.245
Authors: Areej Al-Wabil; Melinda A Smith; Lemuel A Moyé; W Scott Burgin; Lewis B Morgenstern Journal: J Clin Epidemiol Date: 2003-04 Impact factor: 6.437
Authors: Lynda D Lisabeth; Brisa N Sánchez; Ronald D Chervin; Lewis B Morgenstern; Darin B Zahuranec; Susan D Tower; Devin L Brown Journal: Sleep Med Date: 2016-02-12 Impact factor: 3.492