JMIR Publications

ABSTRACT

Background:

Poor sleep quality is increasingly recognized as a contributor to cardiovascular health and stroke risk. Individuals with diabetes, hypertension, obesity, and heart disease are particularly vulnerable, yet the specific influence of sleep characteristics on this high-risk group remains insufficiently understood. Most previous studies have focused on either sleep duration or insomnia alone, with limited evidence integrating multiple sleep dimensions in adults at elevated risk of stroke, particularly in low- and middle-income settings.

Objective:

This study aimed to examine multidimensional sleep characteristics and their associations with demographic, behavioral, and cardiometabolic risk factors among adults at high risk of stroke, as well as to identify discrepancies between subjective sleep perception and objective sleep indicators.

Methods:

This cross-sectional study examined sleep characteristics 303 adults at high risk of stroke with established stroke risk factors. Measures included subjective sleep quality, sleep duration, efficiency, disturbances, use of sleep medication, and daytime dysfunction. Associations with demographic factors, lifestyle behaviors, and comorbidities were analyzed using descriptive statistics and chi-square tests. This study explored multidimensional sleep profiles in relation to cardiometabolic and behavioral risk factors.

Results:

Among 303 adults at high risk of stroke, 65.7% (n = 199) had poor sleep quality. Objective sleep impairment was common, with over half exhibiting low sleep efficiency (<65%) and 26.4% (n = 80) reporting sleep duration <5 hours. Poor sleep quality was significantly associated with cardiometabolic comorbidities, male sex, smoking, irregular sleep patterns, and family history of cardiovascular disease (all p < 0.001), with effect estimates supported by Confidence Intervals (95% CI).

Conclusions:

Sleep disturbances are common among individuals at elevated stroke risk and are shaped by demographic, behavioral, and clinical factors. Although most participants perceived their sleep as adequate, objective indicators revealed marked impairment in sleep duration and efficiency Poor sleep quality is closely associated with cardiometabolic comorbidity and may contribute to increased cerebrovascular vulnerability. Routine sleep assessment, early identification of sleep disorders, and targeted interventions—such as sleep hygiene education and screening for obstructive sleep apnea—are essential for stroke prevention. Further longitudinal research is needed to clarify causal pathways and assess the effectiveness of sleep-focused prevention strategies. Longitudinal studies are warranted to clarify causal pathways and to evaluate the impact of sleep-focused interventions on stroke risk in high-risk populations.