Study On The Relationship Between Sleep Duration And Physical Activity And First Onset Ischemic Stroke

Objective To explore the relationship between sleep duration and physical activity and the first ischemic stroke,analyze the influencing factors of the first ischemic stroke,and establish a decision tree model,so as to play a certain role in early warning of the occurrence of ischemic stroke.Methods From September 2017 to September 2019,320 hospitalized patients(case group)with first ischemic stroke were diagnosed in geriatrics and neurology department of our hospital;279 cases(control group)who were examined in the health examination center of our hospital at the same time and whose age and gender were comparable with the former.collected the data of life behavior and habits,such as sleeping duration,physical activity,tea drinking,drinking,smoking,diet,etc;and demographic data,such as gender,age,height,weight,body mass index(BMI);and Previous diseases history such as hypertension,diabetes,hyperlipidemia,carotid atherosclerosis,cardiovascular disease with a unified questionnaire;SPSS 24.0 was used in the statistical software,the number and percentage of counting data cases were expressed,the measurement data were expressed by x ± s,the counting data were tested by c2 tests,and the measurement data were tested by independent samplet tests.The general clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the relationship between sleep duration,physical activity and the first ischemic stroke,as well as other protective factors and risk factors.Spearman grade correlation analysis was used to analyze the correlation between acute ischemic stroke and sleep duration,physical activity.The difference was statistically significant(P < 0.05).At the same time,IBM SPSS modeler 18.0 software was used to carry out the decision tree C5.0 algorithm,establish the decision tree model of the influencing factors of the first ischemic stroke,and observe the influence of sleep time and physical activity in the decision tree model.Using medcalc 15.2.2 software to draw the decision treemodel and logistic regression model of receiver operating characteristic curve(ROC)curve of ischemic stroke.By comparing the area under the curve(AUC)of the two models,we can compare the ability of the two models to predict the occurrence of the first ischemic stroke.Results 1.Logistic regression analysis showed that sleep duration ? 6h,6h < sleep duration < 7h had statistical significance.Sleep duration ? 6h was the risk factor of first ischemic stroke,6h < sleep duration < 7h was the protective factor of ischemic stroke.Compared with those without physical exercise,those who exercise regularly or occasionally are protective factors.However,men,smoking,high-fat diet,overweight,hypertension,diabetes and hyperlipidemia are independent risk factors of ischemic stroke.Other habits such as interests and tea drinking are protective factors of ischemic stroke.2.The results of decision tree analysis indicated that interest,carotid atherosclerosis,physical exercise,smoking,high-fat diet,drinking,gender,diabetes,hypertension,hyperlipaemia,cardiovascular disease were the influencing factors of the classification node variables of decision tree model,Among them,the interest is the root node influencing factor,and the probability of ischemic stroke of the men who have interest and carotid atherosclerosis is also decreased with the increase of exercise frequency.The probability of ischemic stroke of the women who have high fat diet(77.78%)is higher than that of the normal diet(27.94%).Sleep duration not included in decision tree mode.3.The AUC of decision tree model was0.905(95% CI =0.879-0.927),P < 0.01;the AUC of logistic regression model was 0.875(95% CI=0.846-0.901),P < 0.01.The ROC curves of the two models were compared,P <0.05,which showed that there was statistical significance between the two models,and the area under the curve of the logistic regression model was smaller than that under the curve of the decision tree model,which indicated that the prediction effect of the decision tree model was better than that of the logistic regression model.Conclusion 1.Logistic regression analysis suggests sleep duration ? 6h can increase the risk of the first ischemic stroke,while 6h < sleep time < 7h can reduce the risk of the first ischemic stroke;but sleep duration does not enter the decision tree model.2.Both models suggest that no physical exercise will increase the risk of first-episodeischemic stroke.3.In the prediction of the first ischemic stroke,the prediction effect of decision tree model is better than that of logistic regression model.The decision tree model uses the unique way of "graph + probability" to predict the first ischemic stroke concisely and intuitively,as well as the relationship between the influencing factors.