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By AMERICAN ACADEMY OF NEUROLOGY
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Sleep problems include getting too much or too little sleep, long naps, poor quality sleep, snoring, snorting, and sleep apnea.
The international study involved 4,496 participants and found that
those with five or more sleep-related symptoms had an even greater risk of
stroke. The study does not prove a causal relationship, but rather an
association between sleep problems and stroke risk. Researchers recommend that
improving sleep habits should be a focus for stroke prevention and further
research.
“Not only do our results suggest that individual sleep problems may increase a person’s risk of stroke but having more than five of these symptoms may lead to five times the risk of stroke compared to those who do not have any sleep problems,” said study author Christine Mc Carthy, MB, BCh, BAO, of University of Galway in Ireland.
“Our results suggest that sleep problems should be an area of focus for stroke prevention.”
The international study involved 4,496
people, including 2,243 people who had a stroke who were matched to 2,253
people who did not have a stroke. The average age of participants was 62.
Participants were asked about their
sleep behaviors including how many hours of sleep they got, sleep quality,
napping, snoring, snorting and breathing problems during sleep.
People who slept for too many or too
few hours were more likely to have a stroke than people who slept an average
number of hours. A total of 162 of those who had a stroke got less than five
hours of sleep, compared to 43 of those who did not have a stroke. And 151 of
those who had a stroke got more than nine hours of sleep a night, compared to
84 of those who did not have a stroke.
Researchers found that people who got
less than five hours of sleep were three times more likely to have a stroke
than those who got seven hours of sleep on average. People who got more than
nine hours of sleep were more than two times as likely to have a stroke than
those who got seven hours a night.
People who took naps longer than one
hour were 88% more likely to have a stroke than those who did not.
Researchers also looked at breathing
problems during sleep, including snoring, snorting, and sleep apnea. People who
snored were 91% more likely to have stroke than those who did not and people
who snorted were nearly three times more likely to have a stroke than those who
did not. People with sleep apnea were nearly three times more likely to have a
stroke than those who did not.
Following extensive adjusting for
other factors that could affect the risk of stroke such as smoking, physical
activity, depression, and alcohol consumption, the results remained similar.
“With these results, doctors could
have earlier conversations with people who are having sleep problems,” Mc
Carthy said. “Interventions to improve sleep may also reduce the risk of stroke
and should be the subject of future research.”
A limitation of the study was that
people reported their own symptoms of sleep problems, so the information may
not have been accurate.
Reference: “Sleep Patterns and the
Risk of Acute Stroke: Results from the INTERSTROKE International Case-Control
Study” by Christine Eileen Mc Carthy, Salim Yusuf, Conor Judge, Alberto
Alvarez-Iglesias, Graeme J. Hankey, Shahram Oveisgharan, Albertino Damasceno,
Helle Klingenberg Iversen, Annika Rosengren, Alvaro Avezum, Patricio
Lopez-Jaramillo, Denis Xavier, Xingyu Wang, Sumathy Rangarajan and Martin
O’Donnell, 5 April 2013, Neurology.
DOI:
10.1212/WNL.0000000000207249
The study was supported by Canadian
Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian
Stroke Network, Swedish Research Council, Swedish Heart and Lung Foundation,
The Health & Medical Care Committee of the Regional Executive Board, Region
Västra Götaland, Astra Zeneca, Boehringer Ingelheim (Canada), Pfizer (Canada),
Merck, Sharp and Dohme, UK Chest and UK Heart and Stroke.