A new study shows that sleep disturbances are associated with a significantly increased risk of stroke.
A large international study found that people who slept too little had more than three times the risk of stroke, those who slept too much had more than two times the risk, and those with severe obstructive sleep apnea symptoms had a 2 ~3 times higher (OSA).
The study also showed that the higher the number of sleep disorder symptoms, the higher the risk of stroke. His 11% of study participants with five or more sleep disorder symptoms had a five-fold higher risk of stroke than he did.
Although research data do not show a causal relationship between sleep disturbances and stroke, the link between the two was strong.
Dr. Christine McCarthy
“Given the association, sleep disturbance may represent a marker for people at increased risk of stroke, and further intervention studies are needed to see if management can reduce this risk.” Principal investigator Christine McCarthy, MD, PhD, Physician in Geriatrics and Stroke Medicine, and a researcher at the University of Galway, Galway, Ireland, said: Medscape Medical News“However, for the time being, management of sleep disorders may have a positive impact on patients’ quality of life.”
Here are the findings: publish online April 6 Diary neurology.
More symptoms, more risks
Previous studies have shown severe OSA double the risk It increases the risk of stroke and increases the likelihood of stroke recurrence. A 2019 study found that people with insomnia small increase in risk of stroke.
“Both snoring and excessive sleep duration have been associated with an increased risk of stroke in previous observational studies, but other symptoms of sleep disorders are less known and with inconsistent results.
Also, previous studies were typically from a single geographic region, McCarthy noted, which could limit their generalizability.
For this effort, researchers used data from 4,496 participants in INTERSTROKE, the first international case-control study of acute stroke risk factors. About half of the participants had a history of stroke.
Using information gleaned from a study of sleep habits, researchers found that in people who slept less than 5 hours a night (OR, 3.15; 95% CI, 2.09–4.76) or more than 9 hours a night, found to be at increased risk of stroke. (OR, 2.67; 95% CI, 1.89-3.78) compared to those who slept 7 hours per night.
Participants taking unscheduled naps or naps longer than 1 hour (OR, 2.46; 95% CI, 1.69 – 3.57) and participants reporting poor sleep quality (OR,1.52; 95% CI, 1.32 – 1.75) ) were also at increased risk for stroke.
OSA symptoms were snoring (OR, 1.91; 95% CI, 1.62 – 2.24), snoring (OR, 2.64; 95% CI, 2.17 – 3.20), and respiratory arrest (OR, 2.87; 95% CI, 2.28 – 2.60). ).
The risk of stroke increased with the number of sleep disorder symptoms, with 11% of participants with 5 or more symptoms having the greatest risk (OR, 5.38; 95% CI, 4.03 – 7.18). .
“This study found an association between a wide range of sleep disorder symptoms and stroke, and a graded association with increased symptoms in the international setting.
Researchers aren’t sure what causes higher stroke risk among people with sleep disorders. It is not designed to understand things.
“Sleep disturbances may also have a two-way relationship with many stroke risk factors. For example, sleep disturbances can be symptomatic of and exacerbate disease,” McCarthy said. increase. “Future intervention studies are needed to determine the true direction of the relationship.”
Markers of stroke risk
Comments on survey results Medscape Medical NewsDaniel Lackland, Ph.D., professor of neurology at the South Carolina Medical College in Charleston, said the findings provide additional evidence of a link between sleep and stroke risk.
“The results confirm that sleep disturbance is a potential marker and part of the risk profile,” he said.
Collecting information about sleep using validated assessment tools is an important part of clinical care, especially for patients with other stroke risk factors, Lackland said.
One of the limitations of this study is that data on sleep were only collected at one time point and participants were not followed long-term to see if changes in sleep affect stroke risk.
“This is an important point and should be the focus of future research because it is important in the design of interventions,” Lackland said.
The INTERSTROKE study was supported by the Canadian Institutes of Health Research, the Canadian Heart and Stroke Foundation, the Canadian Stroke Network, the Swedish Research Council, the Swedish Heart and Lung Foundation, the Health and Medical Committee of the Regional Executive Committee, Regional Västra Götaland, Astra Zeneca, Boehringer Ingelheim (Canada). ), Pfizer (Canada), MERCK, Sharp and Dohme, Swedish Heart and Lung Foundation, UK Chest, and UK Heart and Stroke. McCarthy and Lackland have not reported any related financial relationships.
Neurology. Published online April 6, 2023. full text
Kelli Whitlock Burton is a Medscape Medical News reporter covering neurology and psychiatry.
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