Symptoms of Insomnia and Sleep Duration and Their Association with Incident Strokes: Findings from the Population-Based MONICA/KORA Augsburg Cohort Study
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{"title"=>"Symptoms of insomnia and sleep duration and their association with incident strokes: Findings from the population-based MONICA/KORA Augsburg Cohort Study", "type"=>"journal", "authors"=>[{"first_name"=>"A. Katharina", "last_name"=>"Helbig", "scopus_author_id"=>"55883079600"}, {"first_name"=>"Doris", "last_name"=>"Stöckl", "scopus_author_id"=>"37085752300"}, {"first_name"=>"Margit", "last_name"=>"Heier", "scopus_author_id"=>"6701522355"}, {"first_name"=>"Karl Heinz", "last_name"=>"Ladwig", "scopus_author_id"=>"7005806521"}, {"first_name"=>"Christa", "last_name"=>"Meisinger", "scopus_author_id"=>"35242861500"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84941896814", "sgr"=>"84941896814", "pui"=>"606057277", "isbn"=>"1932-6203", "pmid"=>"26230576", "doi"=>"10.1371/journal.pone.0134480"}, "id"=>"9bed3dcc-ddad-3845-8747-d00554675bb6", "abstract"=>"OBJECTIVE: To examine the relationship between symptoms of insomnia and sleep duration and incident total (non-fatal plus fatal) strokes, non-fatal strokes, and fatal strokes in a large cohort of men and women from the general population in Germany.\\n\\nMETHODS: In four population-based MONICA (monitoring trends and determinants in cardiovascular disease)/KORA (Cooperative Health Research in the Region of Augsburg) surveys conducted between 1984 and 2001, 17,604 men and women (aged 25 to 74 years) were asked about issues like sleep, health behavior, and medical history. In subsequent surveys and mortality follow-ups, incident stroke cases (cerebral hemorrhage, ischemic stroke, transient ischemic attack, unknown stroke type) were gathered prospectively until 2009. Sex-specific hazard ratios (HR) and their 95% confidence intervals (CI) were estimated using sequential Cox proportional hazards regression models.\\n\\nRESULTS: During a mean follow-up of 14 years, 917 strokes (710 non-fatal strokes and 207 fatal strokes) were observed. Trouble falling asleep and difficulty staying asleep were not significantly related to any incident stroke outcome in either sex in the multivariable models. Among men, the HR for the association between short (≤5 hours) and long (≥10 hours) daily sleep duration and total strokes were 1.44 (95% CI: 1.01-2.06) and 1.63 (95% CI: 1.16-2.29), after adjustment for basic confounding variables. As for non-fatal strokes and fatal strokes, in the analyses adjusted for age, survey, education, physical activity, alcohol consumption, smoking habits, body mass index, hypertension, diabetes, and dyslipidemia, the increased risks persisted, albeit somewhat attenuated, but no longer remained significant. Among women, in the multivariable analyses the quantity of sleep was also not related to any stroke outcome.\\n\\nCONCLUSION: In the present study, symptoms of insomnia and exceptional sleep duration were not significantly predictive of incident total strokes, non-fatal strokes, and fatal strokes in either sex.", "link"=>"http://www.mendeley.com/research/symptoms-insomnia-sleep-duration-association-incident-strokes-findings-populationbased-monicakora-au", "reader_count"=>25, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>6, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>3, "Student > Master"=>7, "Student > Bachelor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>6, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>3, "Student > Master"=>7, "Student > Bachelor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>9, "Agricultural and Biological Sciences"=>1, "Business, Management and Accounting"=>1, "Sports and Recreations"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Psychology"=>3, "Social Sciences"=>2, "Computer Science"=>2, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>9}, "Social Sciences"=>{"Social Sciences"=>2}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>3}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}}, "reader_count_by_country"=>{"Netherlands"=>1}, "group_count"=>3}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2197647"], "description"=>"<p>Abbreviation: HR: hazard ratio, CI: confidence interval, N: Size of the underlying study population with regard to the particular stroke outcome, h: hour.</p><p>Model 1: crude model (unadjusted).</p><p>Model 2: adjusted for age (continuous) and survey (1, 2, 3, 4).</p><p>Model 3: “Socio-demographic and lifestyle model” was, in addition to model 2, further adjusted for education (low, high), physical activity (>2 h/week, 1 h/week (regular), 1 h/week (irregular), no sport), alcohol consumption (men: 0–39 g/day, ≥40 g/day; women: 0–19 g/day, ≥20 g/day), current smoking activity (yes, no).</p><p>Model 4: The full model (“health status model”) was, in addition to model 3, adjusted for BMI (continuous), hypertension (yes, no), diabetes (yes, no), dyslipidemia (yes, no).</p><p><sup>1</sup> Number of incident stroke cases.</p><p>Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 6,157), non-fatal strokes (N = 6,048), and fatal strokes (N = 5,758) according to self-reported sleep duration (hours per 24 hours), men aged 25 to 74 years.</p>", "links"=>[], "tags"=>["14 years", "hazards regression models.ResultsDuring", "body mass index", "stroke type", "health behavior", "Smoking habits", "Cooperative Health Research", "Ischemic stroke", "multivariable models", "stroke outcome.ConclusionIn", "Multivariable analyses", "monitoring trends", "74 years", "hr", "sequential Cox", "ci", "Sleep duration", "incident stroke outcome", "monica", "Alcohol consumption", "incident stroke cases", "ischemic attack", "Incident Strokes"], "article_id"=>1499945, "categories"=>["Biological Sciences"], "users"=>["A. Katharina Helbig", "Doris Stöckl", "Margit Heier", "Karl-Heinz Ladwig", "Christa Meisinger"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0134480.t004", "stats"=>{"downloads"=>1, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hazard_ratios_and_95_confidence_intervals_for_the_incidence_of_total_strokes_N_6_157_non_fatal_strokes_N_6_048_and_fatal_strokes_N_5_758_according_to_self_reported_sleep_duration_hours_per_24_hours_men_aged_25_to_74_years_/1499945", "title"=>"Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 6,157), non-fatal strokes (N = 6,048), and fatal strokes (N = 5,758) according to self-reported sleep duration (hours per 24 hours), men aged 25 to 74 years.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-31 03:48:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2197645"], "description"=>"<p>Abbreviation: HR: hazard ratio, CI: confidence interval, N: Size of the underlying study population with regard to the particular stroke outcome.</p><p>Model 1: crude model (unadjusted).</p><p>Model 2: adjusted for age (continuous) and survey (1, 2, 3, 4).</p><p>Model 3: “Socio-demographic and lifestyle model” was, in addition to model 2, further adjusted for education (low, high), physical activity (>2 h/week, 1 h/week (regular), 1 h/week (irregular), no sport), alcohol consumption (men: 0–39 g/day, ≥40 g/day; women: 0–19 g/day, ≥20 g/day), current smoking activity (yes, no).</p><p>Model 4: The full model (“health status model”) was, in addition to model 3, adjusted for BMI (continuous), hypertension (yes, no), diabetes (yes, no), dyslipidemia (yes, no).</p><p><sup>1</sup> Number of incident stroke cases.</p><p>Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 7,911), non-fatal strokes (N = 7,796), and fatal strokes (N = 7,456) according to self-reported symptoms of insomnia, men aged 25 to 74 years.</p>", "links"=>[], "tags"=>["14 years", "hazards regression models.ResultsDuring", "body mass index", "stroke type", "health behavior", "Smoking habits", "Cooperative Health Research", "Ischemic stroke", "multivariable models", "stroke outcome.ConclusionIn", "Multivariable analyses", "monitoring trends", "74 years", "hr", "sequential Cox", "ci", "Sleep duration", "incident stroke outcome", "monica", "Alcohol consumption", "incident stroke cases", "ischemic attack", "Incident Strokes"], "article_id"=>1499943, "categories"=>["Biological Sciences"], "users"=>["A. Katharina Helbig", "Doris Stöckl", "Margit Heier", "Karl-Heinz Ladwig", "Christa Meisinger"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0134480.t002", "stats"=>{"downloads"=>7, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hazard_ratios_and_95_confidence_intervals_for_the_incidence_of_total_strokes_N_7_911_non_fatal_strokes_N_7_796_and_fatal_strokes_N_7_456_according_to_self_reported_symptoms_of_insomnia_men_aged_25_to_74_years_/1499943", "title"=>"Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 7,911), non-fatal strokes (N = 7,796), and fatal strokes (N = 7,456) according to self-reported symptoms of insomnia, men aged 25 to 74 years.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-31 03:48:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2197646"], "description"=>"<p>Abbreviation: HR: hazard ratio, CI: confidence interval, N: Size of the underlying study population with regard to the particular stroke outcome.</p><p>Model 1: crude model (unadjusted).</p><p>Model 2: adjusted for age (continuous) and survey (1, 2, 3, 4).</p><p>Model 3: “Socio-demographic and lifestyle model” was, in addition to model 2, further adjusted for education (low, high), physical activity (>2 h/week, 1 h/week (regular), 1 h/week (irregular), no sport), alcohol consumption (men: 0–39 g/day, ≥40 g/day; women: 0–19 g/day, ≥20 g/day), current smoking activity (yes, no).</p><p>Model 4: The full model (“health status model”) was, in addition to model 3, adjusted for BMI (continuous), hypertension (yes, no), diabetes (yes, no), dyslipidemia (yes, no).</p><p><sup>1</sup> Number of incident stroke cases.</p><p>Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 7,835), non-fatal strokes (N = 7,743), and fatal strokes (N = 7,580) according to self-reported symptoms of insomnia, women aged 25 to 74 years.</p>", "links"=>[], "tags"=>["14 years", "hazards regression models.ResultsDuring", "body mass index", "stroke type", "health behavior", "Smoking habits", "Cooperative Health Research", "Ischemic stroke", "multivariable models", "stroke outcome.ConclusionIn", "Multivariable analyses", "monitoring trends", "74 years", "hr", "sequential Cox", "ci", "Sleep duration", "incident stroke outcome", "monica", "Alcohol consumption", "incident stroke cases", "ischemic attack", "Incident Strokes"], "article_id"=>1499944, "categories"=>["Biological Sciences"], "users"=>["A. Katharina Helbig", "Doris Stöckl", "Margit Heier", "Karl-Heinz Ladwig", "Christa Meisinger"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0134480.t003", "stats"=>{"downloads"=>3, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hazard_ratios_and_95_confidence_intervals_for_the_incidence_of_total_strokes_N_7_835_non_fatal_strokes_N_7_743_and_fatal_strokes_N_7_580_according_to_self_reported_symptoms_of_insomnia_women_aged_25_to_74_years_/1499944", "title"=>"Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 7,835), non-fatal strokes (N = 7,743), and fatal strokes (N = 7,580) according to self-reported symptoms of insomnia, women aged 25 to 74 years.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-31 03:48:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2197644"], "description"=>"<p><sup>1</sup> Variable was available for 15,742 individuals.</p><p><sup>2</sup> Variable was available for 15,732 individuals.</p><p><sup>3</sup> Variable was available for 10,945 individuals. Median and interquartile range.</p><p><sup>4</sup> Variable was available for 12,131 individuals.</p><p>Prevalence (%) and mean (±standard deviation) of baseline population characteristics by sex and incident total strokes, men and women aged 25 to 74 years (N = 15,746).</p>", "links"=>[], "tags"=>["14 years", "hazards regression models.ResultsDuring", "body mass index", "stroke type", "health behavior", "Smoking habits", "Cooperative Health Research", "Ischemic stroke", "multivariable models", "stroke outcome.ConclusionIn", "Multivariable analyses", "monitoring trends", "74 years", "hr", "sequential Cox", "ci", "Sleep duration", "incident stroke outcome", "monica", "Alcohol consumption", "incident stroke cases", "ischemic attack", "Incident Strokes"], "article_id"=>1499942, "categories"=>["Biological Sciences"], "users"=>["A. Katharina Helbig", "Doris Stöckl", "Margit Heier", "Karl-Heinz Ladwig", "Christa Meisinger"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0134480.t001", "stats"=>{"downloads"=>1, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_and_mean_177_standard_deviation_of_baseline_population_characteristics_by_sex_and_incident_total_strokes_men_and_women_aged_25_to_74_years_N_15_746_/1499942", "title"=>"Prevalence (%) and mean (±standard deviation) of baseline population characteristics by sex and incident total strokes, men and women aged 25 to 74 years (N = 15,746).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-31 03:48:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2197652"], "description"=>"<div><p>Objective</p><p>To examine the relationship between symptoms of insomnia and sleep duration and incident total (non-fatal plus fatal) strokes, non-fatal strokes, and fatal strokes in a large cohort of men and women from the general population in Germany.</p><p>Methods</p><p>In four population-based MONICA (monitoring trends and determinants in cardiovascular disease)/KORA (Cooperative Health Research in the Region of Augsburg) surveys conducted between 1984 and 2001, 17,604 men and women (aged 25 to 74 years) were asked about issues like sleep, health behavior, and medical history. In subsequent surveys and mortality follow-ups, incident stroke cases (cerebral hemorrhage, ischemic stroke, transient ischemic attack, unknown stroke type) were gathered prospectively until 2009. Sex-specific hazard ratios (HR) and their 95% confidence intervals (CI) were estimated using sequential Cox proportional hazards regression models.</p><p>Results</p><p>During a mean follow-up of 14 years, 917 strokes (710 non-fatal strokes and 207 fatal strokes) were observed. Trouble falling asleep and difficulty staying asleep were not significantly related to any incident stroke outcome in either sex in the multivariable models. Among men, the HR for the association between short (≤5 hours) and long (≥10 hours) daily sleep duration and total strokes were 1.44 (95% CI: 1.01–2.06) and 1.63 (95% CI: 1.16–2.29), after adjustment for basic confounding variables. As for non-fatal strokes and fatal strokes, in the analyses adjusted for age, survey, education, physical activity, alcohol consumption, smoking habits, body mass index, hypertension, diabetes, and dyslipidemia, the increased risks persisted, albeit somewhat attenuated, but no longer remained significant. Among women, in the multivariable analyses the quantity of sleep was also not related to any stroke outcome.</p><p>Conclusion</p><p>In the present study, symptoms of insomnia and exceptional sleep duration were not significantly predictive of incident total strokes, non-fatal strokes, and fatal strokes in either sex.</p></div>", "links"=>[], "tags"=>["14 years", "hazards regression models.ResultsDuring", "body mass index", "stroke type", "health behavior", "Smoking habits", "Cooperative Health Research", "Ischemic stroke", "multivariable models", "stroke outcome.ConclusionIn", "Multivariable analyses", "monitoring trends", "74 years", "hr", "sequential Cox", "ci", "Sleep duration", "incident stroke outcome", "monica", "Alcohol consumption", "incident stroke cases", "ischemic attack", "Incident Strokes"], "article_id"=>1499950, "categories"=>["Biological Sciences"], "users"=>["A. Katharina Helbig", "Doris Stöckl", "Margit Heier", "Karl-Heinz Ladwig", "Christa Meisinger"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0134480", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Symptoms_of_Insomnia_and_Sleep_Duration_and_Their_Association_with_Incident_Strokes_Findings_from_the_Population_Based_MONICA_KORA_Augsburg_Cohort_Study_/1499950", "title"=>"Symptoms of Insomnia and Sleep Duration and Their Association with Incident Strokes: Findings from the Population-Based MONICA/KORA Augsburg Cohort Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-31 03:48:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2197648"], "description"=>"<p>Abbreviation: HR: hazard ratio, CI: confidence interval, N: Size of the underlying study population with regard to the particular stroke outcome, h: hour.</p><p>Model 1: crude model (unadjusted).</p><p>Model 2: adjusted for age (continuous) and survey (1, 2, 3, 4).</p><p>Model 3: “Socio-demographic and lifestyle model” was, in addition to model 2, further adjusted for education (low, high), physical activity (>2 h/week, 1 h/week (regular), 1 h/week (irregular), no sport), alcohol consumption (men: 0–39 g/day, ≥40 g/day; women: 0–19 g/day, ≥20 g/day), current smoking activity (yes, no).</p><p>Model 4: The full model (“health status model”) was, in addition to model 3, adjusted for BMI (continuous), hypertension (yes, no), diabetes (yes, no), dyslipidemia (yes, no).</p><p><sup>1</sup> Number of incident stroke cases.</p><p>Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 5,974), non-fatal strokes (N = 5,885), and fatal strokes (N = 5,745) according to self-reported sleep duration (hours per 24 hours), women aged 25 to 74 years.</p>", "links"=>[], "tags"=>["14 years", "hazards regression models.ResultsDuring", "body mass index", "stroke type", "health behavior", "Smoking habits", "Cooperative Health Research", "Ischemic stroke", "multivariable models", "stroke outcome.ConclusionIn", "Multivariable analyses", "monitoring trends", "74 years", "hr", "sequential Cox", "ci", "Sleep duration", "incident stroke outcome", "monica", "Alcohol consumption", "incident stroke cases", "ischemic attack", "Incident Strokes"], "article_id"=>1499946, "categories"=>["Biological Sciences"], "users"=>["A. Katharina Helbig", "Doris Stöckl", "Margit Heier", "Karl-Heinz Ladwig", "Christa Meisinger"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0134480.t005", "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hazard_ratios_and_95_confidence_intervals_for_the_incidence_of_total_strokes_N_5_974_non_fatal_strokes_N_5_885_and_fatal_strokes_N_5_745_according_to_self_reported_sleep_duration_hours_per_24_hours_women_aged_25_to_74_years_/1499946", "title"=>"Hazard ratios and 95% confidence intervals for the incidence of total strokes (N = 5,974), non-fatal strokes (N = 5,885), and fatal strokes (N = 5,745) according to self-reported sleep duration (hours per 24 hours), women aged 25 to 74 years.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-31 03:48:48"}

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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