Modification Effects Of Migraine Status And Stress Level On The Relationship Between Sleep Disturbance And 10-year Cardiovascular Disease Risk In Hong Kong Women

Longben Tian, Yao Jie Xie

Research output: Chapter in book / Conference proceedingConference article published in proceeding or bookAcademic researchpeer-review


Background: Evidence has shown that worse sleep disturbance, frequent migraine attacks, and higher stress level predicted the higher cardiovascular diseases (CVDs) risk. Also, the significant associations between migraine, stress, and sleep quality have been identified in many previous studies. The purpose of this study was to explore the modification effects of migraine status and stress level on the relationship between sleep disturbance and 10-year CVDs risk in a sample of Hong Kong Chinese women.
Method: Data were analyzed from the Hong Kong Women's Health Study 2019, a cross-sectional survey conducted in Hong Kong female nurses aged 30 years and above between 2019 and 2020. Mailed questionnaires were used for data collection. Sleep quality and stress level were measured by the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS), respectively. The ID Migraine™ screening and doctor-diagnosed migraine that reported by the nurses were used together to identify the migraineurs. The 10-year CVDs risk was calculated by the Framingham 10-year risk score (FRS). The modification effect was tested by the stratified analysis and multiple linear regression model.
Result: In total, 1,344 nurses with a mean age of 46.12 (SD=10.47) were involved in the study. Twenty-one percent of them had migraine and 29.6% had moderate or high level of stress (PSS score > 28). Among 704 (52.4%) participants who had poor sleep quality (Global PSQI score > 5), 96.9% of them had sleep disturbance. The mean score of FRS was 3.6% (3.3%), and 5.1% of the participants had a high level of CVDs risk (FRS≥10%). After adjusting of educational level, employment status, daily fruit and vegetable consumption, postmenopausal status and family history of CVDs, the sleep disturbance score was significantly associated with FRS [β=0.005; 95% confidence interval (CI): 0.003-0.010]. The stronger sleep disturbance-FRS association was observed among migraineurs (β=0.009; 95% CI: 0.004-0.013) and those with moderate or high level of stress (β=0.008; 95% CI: 0.004-0.013).
Conclusion: Migraine status and stress level modified the strength of association between sleep disturbance and 10-year CVDs risk. Among nurses who had sleep disturbance, migraine and high level of stress aggravated the 10-year CVDs risk.
Original languageEnglish
Title of host publicationCirculation
Publication statusPublished - 7 Apr 2022

ASJC Scopus subject areas

  • Health Professions(all)

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