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. 2025 Mar 21;11(1):1-8.
doi: 10.4103/bc.bc_7_24. eCollection 2025 Jan-Mar.

The link between sleep duration and stroke risk

Yu Cheng  1   2 , Yuchuan Ding  3 , Ahmed Elmadhoun  4 , Xunming Ji  5 , Xiaokun Geng  1   2   3
Affiliations

The link between sleep duration and stroke risk

Yu Cheng et al. Brain Circ. .

Abstract

In this review paper, we explore the complex relationship between sleep duration and stroke risk, outlining the association of both insufficient sleep and excessive sleep with an increased risk of cerebrovascular diseases. We explore a U-shaped relationship between sleep duration and cardiovascular outcomes, including stroke. Our review explores findings from cohort studies, meta-analyses, and Mendelian randomization studies, highlighting the nuanced findings and identifying gaps in the current literature. We discussed the direct and indirect effects of sleep duration on stroke risk, considering factors such as atherosclerosis, atrial fibrillation, hypertension, and hyperlipidemia. We also discuss the methodological challenges inherent in current studies, such as the reliance on self-reported sleep measures and the need for more objective and comprehensive assessments. The paper emphasizes the importance of recognizing individual variations in optimal sleep duration and the potential confounding effects of sleep quality and other sleep-related disorders on stroke risk. Furthermore, we explore the potential mechanisms by which sleep duration may influence endothelial function, oxidative stress, and vascular compliance, suggesting areas for future investigation. The paper makes a compelling case for the inclusion of sleep duration as a key factor in stroke prevention strategies, recommending that healthcare professionals proactively assess and manage sleep patterns to mitigate stroke risk.

Keywords: Cardiovascular health and neurovascular integrity; Mendelian randomization studies; excessive and insufficient sleep; observational.

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Conflict of interest statement

Xunming Ji is the Editor-in-Chief, Yuchuan Ding is an Associate Editor-in-Chief, Xiaokun Geng is the Executive Editor-in-Chief of Brain Circulation. The article was subject to the journal’s standard procedures, with peer review handled independently of them and their research groups.

Figures

Figure 1
Figure 1
Research Methodologies and Outcomes in Stroke Studies. This diagram categorizes and compares different types of research methodologies: Cohort Studies, Meta-Analysis, and Mendelian Randomization Studies. It illustrates their findings on the association between sleep duration and stroke risk, highlighting studies where sleep duration is associated with stroke alongside those where no association was found. This visualization integrates evidence from multiple studies, factoring in various contributing elements to provide a comprehensive overview of the research landscape
Figure 2
Figure 2
Mechanisms of Stroke-Related Complications. This flowchart delineates the direct and indirect pathways through which conditions such as hyperlipidemia, hyperglycemia, hypertension, and atrial fibrillation impact blood vessels and blood follow, contributing to the pathogenesis of stroke-related complications
Figure 3
Figure 3
Comprehensive Assessment of Sleep Disorders. This diagram illustrates the various aspects of evaluating sleep disorders, including insomnia, obstructive sleep apnea, and other sleep-duration issues. It details different sleep patterns and the auxiliary examinations used in diagnosis, such as biochemical tests and neuroimaging. The figure highlights the interconnected nature of these assessments in identifying and addressing poor sleep quality. OSA: Obstructive sleep apnea
See this image and copyright information in PMC

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