Habitual sleep duration and spontaneous intracerebral hemorrhage: a prospective UK Biobank cohort study with supporting hospital-based neurosurgical data
- 1Department of Neurosurgery, Jinjiang Municipal Hospital (Shanghai Sixth People’s Hospital Fujian)
- 2Department of Cardiovascular Surgery, The First Hospital of Jilin University
- 3Department of Neurosurgery, The Second Xiangya Hospital, Central South University
Abstract
Background: Abnormal sleep duration has been associated with stroke, but evidence specific to spontaneous intracerebral hemorrhage (sICH) remains limited.
Methods: We conducted a two-part observational study. The prospective UK Biobank analysis included 314,236 participants free of sICH at baseline, among whom 1,387 developed incident sICH. The supporting cross-sectional hospital analysis included 312 patients with imaging-confirmed sICH and 515 non-ICH neurosurgical controls from Jinjiang Municipal Hospital. Habitual sleep duration was categorized as short (<7 h/day), normal (7–9 h/day), or long (>9 h/day). Cox proportional hazards models [hazard ratios (HRs)] and logistic regression [odds ratios (ORs)] were used, together with restricted cubic splines, additional adjustment for medications, blood pressure, and indicators of prevalent ill health, and multiple imputation of missing data. A systemic inflammatory marker score and interaction analyses with false-discovery-rate correction were examined as secondary, exploratory analyses.
Results: Compared with normal sleep, short and long sleep were associated with higher incident sICH risk in the UK Biobank [adjusted HRs 1.14 (95% CI 1.03–1.26) and 1.55 (1.15–2.09)]; the short-sleep association was modest and less robust in sensitivity analyses. Corresponding cross-sectional ORs in the hospital dataset were 1.49 (1.04–2.13) and 2.05 (1.17–3.59), respectively. Restricted cubic splines suggested U-shaped associations in both datasets, with the lowest estimated hazard or odds at approximately 7–8 h/day. Estimates were similar after additional confounder adjustment (HRs 1.10 and 1.43 for short and long sleep, respectively) and multiple imputation (HRs 1.13 and 1.50, respectively). No interaction, including with inflammatory marker burden, remained significant after false-discovery-rate correction, and adjustment for the marker score changed the estimates only modestly.
Conclusion: Both short and long sleep duration were associated with higher incident sICH risk in the UK Biobank and higher odds of sICH in the hospital dataset, with stronger and more consistent associations observed for long sleep. Systemic inflammatory markers neither explained nor reliably modified these associations, and because long sleep may partly reflect prevalent ill health, the long-sleep association warrants cautious interpretation. Sleep duration may be a useful marker of sICH susceptibility.
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BibTeX
@article{dai2026habitual,
title = {{Habitual sleep duration and spontaneous intracerebral hemorrhage: a prospective UK Biobank cohort study with supporting hospital-based neurosurgical data}},
author = {Weichuan Dai and Yuyan Zhu and Liming Yang and Mingming Zhang and Yingxian Chen and Zhongning Fang and Zhen Qi and Pengwei Hou and Xieli Guo},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1960098},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1960098/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Habitual sleep duration and spontaneous intracerebral hemorrhage: a prospective UK Biobank cohort study with supporting hospital-based neurosurgical data
AU - Weichuan Dai
AU - Yuyan Zhu
AU - Liming Yang
AU - Mingming Zhang
AU - Yingxian Chen
AU - Zhongning Fang
AU - Zhen Qi
AU - Pengwei Hou
AU - Xieli Guo
PY - 2026
DA - 2026/10/26
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1960098
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1960098/full
AB - Background: Abnormal sleep duration has been associated with stroke, but evidence specific to spontaneous intracerebral hemorrhage (sICH) remains limited. Methods: We conducted a two-part observational study. The prospective UK Biobank analysis included 314,236 participants free of sICH at baseline, among whom 1,387 developed incident sICH. The supporting cross-sectional hospital analysis included 312 patients with imaging-confirmed sICH and 515 non-ICH neurosurgical controls from Jinjiang Municipal Hospital. Habitual sleep duration was categorized as short (<7 h/day), normal (7–9 h/day), or long (>9 h/day). Cox proportional hazards models [hazard ratios (HRs)] and logistic regression [odds ratios (ORs)] were used, together with restricted cubic splines, additional adjustment for medications, blood pressure, and indicators of prevalent ill health, and multiple imputation of missing data. A systemic inflammatory marker score and interaction analyses with false-discovery-rate correction were examined as secondary, exploratory analyses. Results: Compared with normal sleep, short and long sleep were associated with higher incident sICH risk in the UK Biobank [adjusted HRs 1.14 (95% CI 1.03–1.26) and 1.55 (1.15–2.09)]; the short-sleep association was modest and less robust in sensitivity analyses. Corresponding cross-sectional ORs in the hospital dataset were 1.49 (1.04–2.13) and 2.05 (1.17–3.59), respectively. Restricted cubic splines suggested U-shaped associations in both datasets, with the lowest estimated hazard or odds at approximately 7–8 h/day. Estimates were similar after additional confounder adjustment (HRs 1.10 and 1.43 for short and long sleep, respectively) and multiple imputation (HRs 1.13 and 1.50, respectively). No interaction, including with inflammatory marker burden, remained significant after false-discovery-rate correction, and adjustment for the marker score changed the estimates only modestly. Conclusion: Both short and long sleep duration were associated with higher incident sICH risk in the UK Biobank and higher odds of sICH in the hospital dataset, with stronger and more consistent associations observed for long sleep. Systemic inflammatory markers neither explained nor reliably modified these associations, and because long sleep may partly reflect prevalent ill health, the long-sleep association warrants cautious interpretation. Sleep duration may be a useful marker of sICH susceptibility.
SN - 1664-2295
ER -