Why trouble sleeping could signal higher risk of stroke

Researchers tell The National insomnia symptoms are linked to increased chances of a stroke, especially in young adults

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People having trouble falling asleep, difficulty maintaining sleep and waking up too early could be at higher risk of a stroke, a study has found.

Researchers established a potential link between symptoms of insomnia and an increased risk of stroke, particularly in people under 50.

However, the study, published by the American Academy of Neurology in the journal Neurology, does not establish a cause-and-effect relationship between insomnia and stroke, only an association.

“There are many therapies that can help people improve the quality of their sleep, so determining which sleep problems lead to an increased risk of stroke may allow for earlier treatments or behavioural therapies for people who are having trouble sleeping and possibly reducing their risk of stroke later in life,” study author Dr Wendemi Sawadogo told The National.

The research involved 31,126 participants averaging 61 years of age, none of whom had a history of stroke at the onset of the study.

They were surveyed about their sleep patterns and symptoms of insomnia, and then studied for an average period of nine years. In that time, 2,101 cases of stroke were reported.

The results revealed a 16 per cent increased chance of stroke in people with one to four symptoms of insomnia, compared to those with none, even after adjusting for other risk factors such as alcohol use, smoking and physical activity levels.

Among the participants with five to eight insomnia symptoms, the risk increased by 51 per cent.

The study also highlighted the stronger correlation between insomnia symptoms and stroke risk in participants under 50.

Those in this age group experiencing five to eight symptoms had almost four times the risk of stroke compared to those with no symptoms.

“This difference in risk between these two age groups may be explained by the higher occurrence of stroke at an older age,” Dr Sawadogo said.

“The list of stroke-risk factors such as high blood pressure and diabetes can grow as people age, making insomnia symptoms one of many possible factors. This striking difference suggests that managing insomnia symptoms at a younger age may be an effective strategy for stroke prevention."

Regarding the stronger correlation between insomnia symptoms and stroke risk in people under 50, Dr Sawadogo told The National: “We have noticed in this study that the mean age decreased with increasing insomnia symptom scores, meaning that younger people experienced more insomnia symptoms than older people.

“As people age, they develop additional risk factors for stroke (hypertension, diabetes, atrial fibrillation) that may reduce the contribution of insomnia symptoms towards the development of stroke.”

The study did not distinguish between types of strokes. However, as Dr Sawadogo noted: “In the United States, 87 per cent of all strokes are ischemic and 13 per cent are haemorrhagic.”

The research also showed a higher correlation of insomnia symptoms with stroke in people suffering from so-called comorbidities such as diabetes, hypertension, heart disease and depression.

Dr Sawadogo explained: “We found that insomnia symptoms could increase the risk of having these comorbidities, which in turn may predispose to the development of stroke.”

She suggested adopting good sleep hygiene practices, including regular sleep patterns, avoiding substance abuse and reducing noise and light exposure at night.

She added: “Cognitive behavioural therapies and pharmacological therapies could help as you discuss them with your healthcare provider”.

Young people experiencing symptoms of insomnia should be cognisant of these potential health outcomes and should discuss any sleep issues with their healthcare providers.

As a key takeaway from this study, Dr Sawadogo emphasised the message that “insomnia symptoms could increase the risk of having a stroke, especially for those younger than 50 years”.

Updated: June 08, 2023, 6:26 AM