Title: Daytime Napping and Ischemic Stroke Risk: Evidence from a Meta-analysis (P2-5.014)
Authors: Vishnu Vardhan Byroju, Jamir Pitton Rissardo, and Ana Leticia Fornari Caprara
Conference: 2026 AAN, Chicago, IL
Objective
To evaluate whether daytime napping is associated with an increased risk of ischemic stroke.
Background
Daytime napping is a common behavior globally, yet its impact on cerebrovascular outcomes remains uncertain. While some studies suggest restorative benefits, others raise concerns about increased vascular risk. Clarifying this association is important for public health recommendations.
Design/Methods
A systematic search of PubMed was conducted using the terms “ischemic stroke” and “nap.”We included observational studies comparing the incidence of ischemic stroke between habitual nappers and non-nappers. Odds ratios (OR) with 95% confidence intervals (CI) were pooled using a random-effects model with the restricted maximum likelihood (REML) estimator. Between-study heterogeneity was assessed using Cochran’s Q and I² statistics. Potential publication bias was evaluated using fail-safe N methods.
Results
Two studies (n = 43,992 participants) were included. In Zhou et al. (2020), 793 strokes occurred among 19,742 nappers versus 325 strokes among 12,008 non-nappers. In Wu et al. (2024), 1,177 strokes occurred among 8,702 nappers versus 317 strokes among 2,550 non-nappers. The fixed-effect model indicated a significant association between napping and stroke (OR = 1.29; 95% CI: 1.18–1.42; p < 0.001). However, the random-effects model showed a non-significant association (OR = 1.29; 95% CI: 0.95 to 1.75; p = 0.10), with high heterogeneity (I² = 90%). Fail-safe N analyses suggested limited robustness (Rosenthal’s N = 0; Orwin’s N = 2), indicating susceptibility to publication bias.
Conclusions
Current evidence from two large cohorts suggests no significant association between daytime napping and stroke risk under a random-effects model, despite fixed-effect findings suggesting a possible association. The discrepancy likely reflects limited study number and methodological differences. Larger, well-designed prospective studies are needed to clarify causality and inform clinical guidance.
Citation
Byroju VV, Rissardo JP, Caprara AL. Daytime Napping and Ischemic Stroke Risk: Evidence from a Meta-analysis (P2-5.014). Neurology 2026;106(11_suppl_1):788. doi: 10.1212/WNL.0000000000213115.
Figure 1. Fixed-effect forest plot showing increased ischemic stroke risk among habitual nappers, driven by large cohorts.
Figure 2. Random-effects forest plot demonstrating non-significant association between daytime napping and stroke risk, with substantial heterogeneity.