Multidimensional Sleep Characteristics and Cardiometabolic Comorbidity in Adults at Elevated Risk of Stroke (Preprint)

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 (