Chronic insomnia may increase stroke risk

  • Everyone has sleep problems sometimes, but chronic insomnia – persistent sleep disorders – affects about 30% of the general population.
  • Chronic insomnia can affect mental functioning and can increase the risk of depression and anxiety.
  • It is also associated with health problems, such as heart disease, kidney disease, high blood pressure, diabetes, stroke, and obesity.
  • Now, a study has found that people who report regular trouble sleeping are at a higher risk of stroke than those who regularly get a good night’s sleep.

Difficulty falling asleep or waking up during the night are occasional problems for most of us. However, getting a good night’s sleep is a difficult goal for some people because they suffer from persistent sleep disorders. According to the American Academy of Sleep Medicine, this chronic insomnia affects about 30% of the general population.

Chronic insomnia is associated with an increased risk of accidents, high rates of absenteeism from work and decreased concentration. It can also decrease quality of life and increase the use of health services.

Studies have found an association with mental health problems. A 2005 study found that people with insomnia are almost ten times more likely to have clinically significant depression and about 17 times more likely to have clinically significant anxiety than those without insomnia. However, the direction of the relationship between depression, anxiety, and insomnia is unclear.

The effects are not just mental. According to National Institutes of HealthLack of sleep is linked to many chronic health conditions, including heart diseasekidney disease, high blood pressurediabetes, strokeAnd obesity.

A new study has provided more evidence of the link between insomnia and strokes. In this study, people who reported the highest number of insomnia symptoms had a 51% higher risk of stroke than those who reported no insomnia symptoms.

The study is published in Neurologythe medical journal of the American Academy of Neurology.

The study used data from 2002 to 2020 from the Health and Retirement Study in the USA. Of the 31,126 participants, 92.5% were aged 50 and over, and not all had suffered a stroke at the start of the study. They had an average age of 61, 57% were female, and 63% were non-Hispanic white.

Participants recorded their insomnia symptoms by completing the Brief Insomnia Questionnaire (BIQ), a validated screening tool assessing self-reported sleep complaints. They answered four questions about how often they:

  • had trouble falling asleep
  • had trouble waking up at night
  • woke up too early and couldn’t get back to sleep
  • felt rested in the morning

For each, they had to answer “most of the time”, “sometimes” or “rarely or never”.

The total score for their responses ranged from 0 – no insomnia – to 8, indicating severe insomnia symptoms. The researchers repeated the insomnia questionnaires during follow-up and found that people’s insomnia symptoms were consistent.

Researchers recorded strokes from interviews every two years over a follow-up of up to 19 years (median 9.2 years), during which participants were asked: “A doctor ever tell you that you had a stroke? “.

After adjusting for other factors that may increase stroke risk, including alcohol consumption, smoking, and level of physical activity, the researchers found that the higher the insomnia symptom score, the the higher the risk of having a stroke during follow-up.

People with the highest number of insomnia symptoms (5 to 8) had a 51% higher risk of stroke than those with no insomnia symptoms.

The researchers found that the link between insomnia and stroke was strongest in people under 50. People in this younger group with insomnia symptom scores of five to eight had almost four times the risk of stroke of those under 50 without insomnia symptoms.

Dr. Wendemi Sawadogo, Ph.D.Senior author of the study, commented: “We noticed in this study that mean age decreased with increasing insomnia symptom scores, meaning that younger people had more insomnia symptoms. than the elderly.”

“Furthermore, as people age, they develop additional risk factors for stroke (hypertension, diabetes, atrial fibrillation…) that may reduce the contribution of insomnia symptoms to the development of stroke,” she said. Medical News Today.

“The link between poor sleep and stroke in older patients is probably weaker because the risk of stroke in general is much higher in older people across all domains. As patients age, the influence relative sleep decreases compared to their other health problems such as hypertension, diabetes and heart disease.

Dr. Adi Iyerneurosurgeon and interventional neuroradiologist, Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

For all participants, the association increased further for people with diabetes, hypertension, heart disease and depression.

The authors point out that their results do not show that insomnia causes stroke, but highlight an independent association between the two. They also acknowledge that a limitation of the study was that insomnia symptoms were self-reported.

Sleep deprivation has been shown to contribute to endocrine and metabolic dysregulationas Dr. Iyer explained:

“Poor sleep likely causes inflammatory and metabolic dysregulation associated with diabetes, heart disease (and) high blood pressure, which are known risk factors for stroke.”

Discussing the study results, Dr Sawadogo stressed that people should “be aware of the potential adverse health effects associated with poor sleep and discuss any sleep issues with your healthcare provider.”

If you suffer from insomnia, the following may help you sleep better:

  • Establish a routine by going to bed and waking up at around the same time each day.
  • Avoid using screens just before bedtime and keep devices out of the bedroom.
  • Avoid heavy meals, caffeine or too much alcohol in the evening.
  • Relax before bedtime, for example by taking a bath, listening to relaxing music, or doing breathing or relaxation exercises.
  • Make sure your bedroom is dark with heavy curtains or blackout blinds.

When self-medication does not improve sleep, Dr. Iyer, who was not involved in the study, recommended seeking additional help:

“Sleep disturbances should be treated like any other serious health condition because they have long-term implications for overall health, including stroke risk. The importance of this study is that clinicians can help optimize sleep habits to reduce the risk of stroke, especially in young patients.

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