Association between sleep quality and stroke risk stratification in middle-aged and older adults in China

This study aims to examine the association between sleep quality and stroke risk stratification among middle-aged and older adults in a Chinese community-based population. A total of 3489 permanent residents of Fuyang, Anhui Province-each residing in the area for at least six months annually-were selected through multistage stratified cluster random sampling. Stroke risk was categorized as high, moderate, or low. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Logistic regression analysis was conducted to examine associations between sleep quality and stroke risk level. The study population included 1,555 individuals in the low-risk group, 1,097 in the moderate-risk group, and 837 in the high-risk group, with a mean age of 57 years (range: 49-69 years). Females constituted 63.37 % (n = 2,211) of the sample. The prevalence of poor sleep quality was 28.50 %, with a higher proportion observed among females compared to males (30.57 % vs. 24.88 %). Multivariable logistic regression analysis identified age, sex, history of stroke, and stroke risk stratification as significant factors associated with poor sleep quality (p < 0.05). Further analysis demonstrated that stroke risk stratification was significantly associated with sleep latency in both model 1 (p = 0.002) and model 2 (p = 0.007), and with daytime dysfunction in model 3 (p = 0.049). An elevated risk of stroke was associated with reduced sleep quality, particularly in relation to sleep latency and daytime dysfunction. These cross-sectional findings underscore the importance of evaluating sleep characteristics in individuals at increased risk of stroke, though causality cannot be inferred.