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Due to contentious associations between sleep and stroke risk we performed a meta-analysis of cohort studies and utilized Mendelian randomization (MR).    Material and methods  For the meta-analysis we pooled prospective studies and then reviewed the largest genome-wide association studies regarding self-reported or accelerometer-derived sleep duration with stroke [ischemic (IS), cardioembolic (CES), large artery (LAS), small vessel (SVS)]. Inverse variance weighted method (IVW), weighted median (WM)-based method, MR-Egger and MR-Pleiotropy RESidual Sum and Outlier (PRESSO) were performed. To determine the impact of single nucleotide polymorphisms (SNPs) leave-one-out method was applied.    Results  Pooled prospective studies demonstrated shorter ( 8h) [n=16 studies, I2 = 53.6, p  0.126). Estimated associations had no significant heterogeneity and MR-PRESSO revealed no outliers. There was low likelihood of pleiotropy (all estimations p &gt;0.539) and associations were not driven by single SNPs.    Conclusions  Meta-analysis revealed shorter and longer sleep increased total stroke risk, but with high heterogeneity. MR analysis showed no causal associations between sleep duration and stroke risk.

Sleep Duration May Not Have Any Effect on The Risk of Stroke: Insights from Mendelian Randomization and Prospective Cohort Studies