THE ROLE OF NAPS AND DAYTIME SLEEPINESS IN STROKE RISK: A REVIEW OF THE LITERATURE FROM A PUBLIC HEALTH AND SLEEP-MONITORING TECHNOLOGY PERSPECTIVE

Keywords: Stroke, Nap, Sleep Monitoring Technologies, Daytime Sleepiness

Abstract

The aim of this review is to summarize the literature on daytime naps and their duration in relation to stroke risk, with particular emphasis on physiological mechanisms, demographic factors, and lifestyle. Analysis has shown that short naps of up to 30 minutes improve cognitive functions, blood pressure regulation, and stress hormone levels, and thus may have not only a neutral but also a beneficial effect on the human body. In contrast, long naps lasting 60–90 minutes or repeated multiple times during the day appear to significantly increase the risk of stroke, especially in older individuals with comorbidities such as diabetes, obesity, or hypertension. The mechanisms linking naps to stroke risk include changes in the autonomic nervous system, blood pressure, inflammatory status, and blood–brain barrier integrity. The authors emphasize that both nighttime sleep and daytime naps can be monitored for duration and quality using modern, widely available devices, such as wrist-worn trackers or mattress-embedded sensors, allowing objective assessment of sleep patterns and early identification of stroke risk factors. Further research is needed to develop systems for early detection of abnormal sleep and nap patterns, which could serve as a basis for implementing personalized stroke prevention strategies.

References

Song, Y., Liu, H., & Liu, Y. (2024). The association between nap time, nighttime sleep and depression in Chinese older adults: A cross-sectional study. PloS one, 19(6), e0302939. https://doi.org/10.1371/journal.pone.0302939

Dutheil, F., Danini, B., Bagheri, R., Fantini, M. L., Pereira, B., Moustafa, F., Trousselard, M., & Navel, V. (2021). Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(19), 10212. https://doi.org/10.3390/ijerph181910212

Wichniak, A., Jankowski, K. S., Skalski, M., Skwarło-Sońta, K., Zawilska, J. B., Żarowski, M., Poradowska, E., & Jernajczyk, W. (2017). Treatment guidelines for Circadian Rhythm Sleep-Wake Disorders of the Polish Sleep Research Society and the Section of Biological Psychiatry of the Polish Psychiatric Association. Part I. Physiology, assessment and therapeutic methods. Standardy leczenia zaburzeń rytmu okołodobowego snu i czuwania opracowane przez Polskie Towarzystwo Badań nad Snem i Sekcję Psychiatrii Biologicznej Polskiego Towarzystwa Psychiatrycznego. Część I. Fizjologia, metody oceny i oddziaływania terapeutyczne. Psychiatria polska, 51(5), 793–814. https://doi.org/10.12740/PP/OnlineFirst/66810

Borbély A. (2022). The two-process model of sleep regulation: Beginnings and outlook. Journal of sleep research, 31(4), e13598. https://doi.org/10.1111/jsr.13598

Kim, J. H., Elkhadem, A. R., & Duffy, J. F. (2022). Circadian Rhythm Sleep-Wake Disorders in Older Adults. Sleep medicine clinics, 17(2), 241–252. https://doi.org/10.1016/j.jsmc.2022.02.003

Duss, S. B., Brill, A. K., Bargiotas, P., Facchin, L., Alexiev, F., Manconi, M., & Bassetti, C. L. (2018). Sleep-Wake Disorders in Stroke-Increased Stroke Risk and Deteriorated Recovery? An Evaluation on the Necessity for Prevention and Treatment. Current neurology and neuroscience reports, 18(10), 72. https://doi.org/10.1007/s11910-018-0879-6

Khot, S. P., & Morgenstern, L. B. (2019). Sleep and Stroke. Stroke, 50(6), 1612–1617. https://doi.org/10.1161/STROKEAHA.118.023553

Shen, Y., Lv, Q. K., Xie, W. Y., Gong, S. Y., Zhuang, S., Liu, J. Y., Mao, C. J., & Liu, C. F. (2023). Circadian disruption and sleep disorders in neurodegeneration. Translational neurodegeneration, 12(1), 8. https://doi.org/10.1186/s40035-023-00340-6

Fang, W., Li, Z., Wu, L., Cao, Z., Liang, Y., Yang, H., Wang, Y., & Wu, T. (2013). Longer habitual afternoon napping is associated with a higher risk for impaired fasting plasma glucose and diabetes mellitus in older adults: results from the Dongfeng-Tongji cohort of retired workers. Sleep medicine, 14(10), 950–954. https://doi.org/10.1016/j.sleep.2013.04.015

Meyer, N., Lok, R., Schmidt, C., Kyle, S. D., McClung, C. A., Cajochen, C., Scheer, F. A. J. L., Jones, M. W., & Chellappa, S. L. (2024). The sleep-circadian interface: A window into mental disorders. Proceedings of the National Academy of Sciences of the United States of America, 121(9), e2214756121. https://doi.org/10.1073/pnas.2214756121

Kaźmierski, R., Jurga, S., Wojtasz, I., Kostanek, J., Łukasik, M., & Watala, C. (2025). Nonobvious connections between napping and stroke: a systematic review and meta-analysis. Sleep medicine reviews, 84, 102157. https://doi.org/10.1016/j.smrv.2025.102157

Jin, X., Chen, H., Li, Y., Xu, W., Chen, X., Tian, L., & Teng, W. (2021). Association between daytime napping and stroke: A dose-response meta-analysis. Journal of sleep research, 30(5), e13366. https://doi.org/10.1111/jsr.13366

Yang, M. J., Zhang, Z., Wang, Y. J., Li, J. C., Guo, Q. L., Chen, X., & Wang, E. (2022). Association of Nap Frequency With Hypertension or Ischemic Stroke Supported by Prospective Cohort Data and Mendelian Randomization in Predominantly Middle-Aged European Subjects. Hypertension (Dallas, Tex. : 1979), 79(9), 1962–1970. https://doi.org/10.1161/HYPERTENSIONAHA.122.19120

Holder, S., & Narula, N. S. (2022). Common Sleep Disorders in Adults: Diagnosis and Management. American family physician, 105(4), 397–405.

Sun, J., Ma, C., Zhao, M., Magnussen, C. G., & Xi, B. (2022). Daytime napping and cardiovascular risk factors, cardiovascular disease, and mortality: A systematic review. Sleep medicine reviews, 65, 101682. https://doi.org/10.1016/j.smrv.2022.101682

Brindle, R. C., & Conklin, S. M. (2012). Daytime sleep accelerates cardiovascular recovery after psychological stress. International journal of behavioral medicine, 19(1), 111–114. https://doi.org/10.1007/s12529-011-9150-0

Yang, Y. B., Zheng, Y. B., Sun, J., Yang, L. L., Li, J., Gong, Y. M., Li, M. Z., Wen, X., Zhao, H. Y., Shi, P. P., Yu, G. H., Yu, Z. L., Chen, Y., Yuan, K., Deng, J. H., Li, S. X., Yang, Y. F., Zhang, Z. H., Vitiello, M. V., Shi, J., … Bao, Y. P. (2024). To nap or not? Evidence from a meta-analysis of cohort studies of habitual daytime napping and health outcomes. Sleep medicine reviews, 78, 101989. https://doi.org/10.1016/j.smrv.2024.101989

Faraut, B., Andrillon, T., Vecchierini, M. F., & Leger, D. (2017). Napping: A public health issue. From epidemiological to laboratory studies. Sleep medicine reviews, 35, 85–100. https://doi.org/10.1016/j.smrv.2016.09.002

Botonis, P. G., Koutouvakis, N., & Toubekis, A. G. (2021). The impact of daytime napping on athletic performance - A narrative review. Scandinavian journal of medicine & science in sports, 31(12), 2164–2177. https://doi.org/10.1111/sms.14060

Chen, C., Guo, Q., Cheng, Y., Lan, Y., Cheng, D., & Huang, J. (2024). Naps and cardiovascular disease risk in different age and sex groups: evidence from a large community cohort. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 20(8), 1339–1348. https://doi.org/10.5664/jcsm.11154

Yang, M. J., Zhang, Z., Wang, Y. J., Li, J. C., Guo, Q. L., Chen, X., & Wang, E. (2022). Association of Nap Frequency With Hypertension or Ischemic Stroke Supported by Prospective Cohort Data and Mendelian Randomization in Predominantly Middle-Aged European Subjects. Hypertension (Dallas, Tex. : 1979), 79(9), 1962–1970. https://doi.org/10.1161/HYPERTENSIONAHA.122.19120

Díaz-Gutiérrez, J., Goni, L., Martínez-González, M. Á., Barón-Esquivias, G., Bazal, P., de la Fuente-Arrillaga, C., Barrio-López, M. T., Bes-Rastrollo, M., & Ruiz-Canela, M. (2025). Sleeping and the risk of atrial fibrillation: a prospective study in the SUN cohort. European journal of preventive cardiology, zwaf377. Advance online publication. https://doi.org/10.1093/eurjpc/zwaf377

Lin L, Huang J, Liu Z, Chen P, Huang C. Associations of siesta and total sleep duration with hypertension or cardiovascular diseases in middle-aged and older adults. Clin Cardiol. 2023 Feb;46(2):159-170. doi: 10.1002/clc.23954. Epub 2022 Dec 12. PMID: 36510696; PMCID: PMC9933105.

Yang, X. H., Liu, Y., Jiang, X. X., Zhang, Z. X., Lu, Y. J., Fu, C. S., Jin, H. M., & Ye, Z. B. (2025). Daytime napping and risk of incident main adverse cardiovascular events and mortality among adults with type 2 diabetes. Diabetes research and clinical practice, 222, 112067. https://doi.org/10.1016/j.diabres.2025.112067

Yamada, T., Hara, K., Shojima, N., Yamauchi, T., & Kadowaki, T. (2015). Daytime Napping and the Risk of Cardiovascular Disease and All-Cause Mortality: A Prospective Study and Dose-Response Meta-Analysis. Sleep, 38(12), 1945–1953. https://doi.org/10.5665/sleep.5246

Edgley, K., Chun, H. Y., Whiteley, W. N., & Tsanas, A. (2023). New Insights into Stroke from Continuous Passively Collected Temperature and Sleep Data Using Wrist-Worn Wearables. Sensors (Basel, Switzerland), 23(3), 1069. https://doi.org/10.3390/s23031069

Wang, J. E., Sindorf, J., Chen, P. W., Wu, J., Gonzales, A., O'Brien, M. K., Sunderrajan, A., Knutson, K. L., Zee, P. C., Wolfe, L., Arora, V. M., & Jayaraman, A. (2024). Assessing actigraphy performance for daytime sleep detection following stroke: insights from inpatient monitoring in a rehabilitation hospital. Sleep advances : a journal of the Sleep Research Society, 5(1), zpae057. https://doi.org/10.1093/sleepadvances/zpae057

Ravindran, K. K. G., Della Monica, C., Atzori, G., Lambert, D., Hassanin, H., Revell, V., & Dijk, D. J. (2023). Contactless and longitudinal monitoring of nocturnal sleep and daytime naps in older men and women: a digital health technology evaluation study. Sleep, 46(10), zsad194. https://doi.org/10.1093/sleep/zsad194

Published
2026-02-02
Citations
How to Cite
Maria Nowakowska, Oliwia Jerzyńska, Miszela Kałachurska, Martyna Rożek, Aleksandra Kowalewska-Kurek, Aleksandra Lisowska, Bartosz Nowak, Maria Sierant, Mateusz Gural, & Constancia Esther Guy. (2026). THE ROLE OF NAPS AND DAYTIME SLEEPINESS IN STROKE RISK: A REVIEW OF THE LITERATURE FROM A PUBLIC HEALTH AND SLEEP-MONITORING TECHNOLOGY PERSPECTIVE. International Journal of Innovative Technologies in Social Science, (1(49). https://doi.org/10.31435/ijitss.1(49).2026.4807

Most read articles by the same author(s)