A new study highlights the link between various sleep problems and an increased risk of stroke. Researchers have studied the link between sleep problems and the risk of stroke. They found that sleep problems increased the incidence of stroke fivefold.
Quality sleep is essential for good health. Sleep problems range from having too little or too long sleep duration, difficulty falling asleep and staying asleep, and symptoms such as snoring, snorting, and pauses in breathing. Studies show that obstructive sleep apnea is associated with strokes. It is not yet known whether other sleep disorders are linked to strokes. Knowing more about how sleep problems can affect stroke risk could help inform prevention strategies.
Recently, researchers have studied the link between sleep problems and the incidence of acute strokes. They found that the more sleep problems individuals had, the more likely they were to experience a stroke. The study is published in the journal Neurology.
If independent physiological changes related to poor sleep may predispose to stroke, it is likely that sleep in general represents an epiphenomenon of known risk factors for stroke such as obesity, advanced age, alcohol consumption, etc. Sleep can be a modifiable risk factor for stroke and clinicians should assess patients’ sleep quality and duration.
Sleep problems and stroke risk
For the study, researchers analyzed health data from 1,799 participants who had suffered an ischemic stroke, the most common type of stroke, in which a blood clot blocks an artery leading to the brain. They also analyzed data from 439 people with intracerebral hemorrhage (ICH), bleeding into brain tissue, and 4,496 age- and sex-matched controls. The participants were on average 62 years old.
Finally, the researchers asked the participants about their sleep patterns, including sleep duration and quality, in the month before the stroke. In the end, the researchers found that multiple sleep problems were linked to an increased incidence of strokes. Specifically, people who slept less than 5 hours a night were three times more likely to experience a stroke than those who slept 7 hours. In addition, the risk of stroke was doubled for people sleeping more than 9 hours per night compared to those sleeping 7 hours.
Sleep apnea (pauses in breathing several times per hour) was linked to a three times higher risk of stroke. Napping for an hour or more was also linked to an 88% higher risk of stroke than no nap. Researchers also found that people who snore were 91% more likely to have a stroke than those who didn’t snore, and those who snored were almost three times more likely to have a stroke than those who snored. didn’t snore. They also found that the more sleep problems individuals had, the more likely they were to experience a stroke or ICH.
Not only do these results suggest that individual sleep problems may increase the risk of stroke, but having more than five of these symptoms may result in a five times higher risk of stroke than in people who have no sleep problems. The results held even after the researchers controlled for potential confounders, including depression, alcohol consumption and physical activity.
Sleep, this third pillar of health
80% of adult sleep is non-REM sleep and during this period the cardiovascular system is controlled by the autonomic nervous system which reduces blood pressure, heart rate and cardiovascular strain. These factors have a protective effect on cardiovascular health. Sleep disturbances, including sleep apnea, insomnia, and night work, can impair this protective effect by reducing the time spent in non-REM sleep. When this happens, there is a decrease in cardiovascular recovery but also a significant increase in stress on the cardiovascular system.
Poor quality sleep, through reduced non-REM sleep, also activates a host of other mechanisms, including injury from intermittent hypoxia, blood pressure changes, cardiac arrhythmia, inflammation, insulin resistance, stress hormone activation, and hypercoagulability, all of which can cause cardiovascular disease, including stroke.
Sleep is increasingly recognized as the third pillar of health, along with diet and exercise, although it has not been studied as extensively
Still, it’s hard to say whether sleep problems cause stroke risk factors or vice versa. For example, increased alcohol consumption can lead to disturbances in sleep quality, but impaired sleep quality can lead to increased use of alcohol as a sedative. Future interventional research is needed to determine causal associations.
Other implications
The study results also encourage physicians to ask about their patients’ sleep habits when they see them in the office. Sleep is rarely addressed routinely in the office, and physicians may miss an opportunity to improve their patients’ health by detecting sleep disturbances earlier.
These results suggest that symptoms of sleep disturbances may represent risk factors for stroke and/or that their presence can identify individuals at increased risk for stroke. The study does not show that sleep disturbances cause strokes. It only shows an association. Given these findings, future studies should look at interventions for sleep disorders and their ability to reduce the risk of stroke.
