Sleep pattern, encompassing characteristics such as long or short duration, impaired quality, difficulty in falling asleep is significantly associated with risk of acute stroke, according to a new study published in the journal Neurology.¹

To examine the association between sleep impairment and risk for acute stroke, researchers recruited 4496 age- and sex-matched participants who presented with first acute stroke in the international INTERSTROKE case-control study; of these, 1799 patients had ischemic stroke and 439 patients had intracerebral hemorrhage. A questionnaire was used to evaluate sleep in terms of nocturnal sleep duration, sleep quality, sleep onset latency, nocturnal awakening and breathing-related sleep problems.

After adjusting for sociodemographic and behavioral risk factors, patients who reported sleeping for less than 5 hours or more than 9 hours were thrice more likely to suffer a stroke with odds ratio of 3.15 and 2.67 respectively. The risk of acute stroke was also increased in persons with impaired sleep quality (OR 1.52), those who found it difficult to sleep (OR 1.32) or maintain sleep (OR 1.33) or unplanned napping (OR 1.59). Persons who napped for more than one hour and snored during sleep doubled their risk of acute stroke with ORs of 1.88 and 1.91 respectively. Persons with sleep apnea also had 3-folds higher risk of acute stroke (OR 2.87). As the number of sleep problems increased, so did the increase in the probability of acute stroke.

These findings suggest that sleep pattern may be a significant but modifiable risk factor for acute stroke. The associations, as demonstrated in this study, enable identification of at-risk individuals. The authors advocate further studies to examine the impact of sleep interventions in prevention of stroke.  

Reference

1. Mc Carthy CE, et al. Sleep patterns and the risk of acute stroke: results from the INTERSTROKE international case-control study. Neurology Apr 2023, 10.1212/WNL.0000000000207249; DOI: 10.1212/WNL.0000000000207249.