Journal of Biology and Medicine: Open Access

Abstract 

Objective: To determine the gender differences in the effect of sleep disturbances (SD) on risk of myocardial infarction (MI) and stroke in an open population 25-64 years in Russia/Siberia over 16 years of follow-up. Methods: Within the framework of the III screening of WHO's MONICApsychosocial program, a random representative sample of the population of both sexes of 25-64 years of Novosibirsk in 1994 (men n = 657, women: n = 689) was examined. The screening included: socio-demographic data, the definition of the SD. The SD studied by means of the Jenkins scale. The analysis included persons of both sexes without myocardial infarction, stroke. New-onset cases of MI and stroke in women - 15 and 35 cases and in men - 30 and 22 cases, respectively detected in the cohort over 16 years of follow-up. To assess the risk taking into account the different control times a single-factor and multivariate regression models of proportional Cox risks (Cox-regression) were used. Results: In the open population aged of 25-64 years 48,6% of men and 65,9% of women had SD (x2 = 24,427 df = 1 p = 0,0001). In a single-factor Cox regression analysis the risk of stroke was higher among men than among women with SD over 16-year period. Multivariate regression analysis revealed that risk of stroke in men and women is approximately the same among people with SD. Widowed men with SD had an increased risk of developing a stroke. The risk of stroke was higher in men with primary education than women. There was an increased risk of stroke in women with college degree and with sleep problems. Cox single-factor regression analysis showed an increased risk of MI in men with SD over 16-year period in 2.4 times. The influence of SD on the risk of MI in women has not been received. The risk of MI among men with SD who never married was 3-fold, in divorced was 4.3-fold and in widowed men risk MI was 7.5-fold higher than without SD. Conclusion: Sleep disorders are a significant risk factor of stroke in both men and women. The risk of myocardial infarction was only increased in men. A disadvantaged social gradient (single, divorced, widowed) in men was an additional risk factor of myocardial infarction, supplemented by an increased risk of stroke in widowed men. Moreover, primary education was an additional risk factor of stroke in both men and women. 

Keywords: Sleep; Gender differences; Sleep disturbance; Myocardial infarction; Stroke; and Relative risk.