The following is a summary of “Sleep Patterns and the Risk of Acute Stroke,” published in the May 2023 issue of Neurology by Carthy, et al.

Sleep disturbance symptoms are prevalent and may contribute to the risk of ischemic stroke. Understanding the association between various sleep disturbance symptoms and acute stroke is crucial. For a study, researchers sought to investigate the association in an international setting.

The study utilized data from the INTERSTROKE study, which included patients presenting with their first acute stroke and age- and sex-matched controls. A questionnaire was administered to assess sleep disturbance symptoms experienced in the month preceding the study. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs, adjusting for age, occupation, marital status, and baseline-modified Rankin scale. Additional models considered potential mediators, including behavioral and disease risk factors.

A total of 4,496 matched participants were included in the study. Among them, 1,799 experienced ischemic stroke, and 439 had intracerebral hemorrhage. In the primary model, several sleep disturbance symptoms were significantly associated with increased odds of acute stroke. These included short sleep duration (<5 hours) (OR 3.15, 95% CI 2.09–4.76), long sleep duration (>9 hours) (OR 2.67, 95% CI 1.89–3.78), impaired sleep quality (OR 1.52, 95% CI 1.32–1.75), difficulty falling asleep (OR 1.32, 95% CI 1.13–1.55), difficulty maintaining sleep (OR 1.33, 95% CI 1.15–1.53), unplanned napping (OR 1.48, 95% CI 1.20–1.84), prolonged napping (>1 hour) (OR 1.88, 95% CI 1.49–2.38), snoring (OR 1.91, 95% CI 1.62–2.24), snorting (OR 2.64, 95% CI 2.17–3.20), and breathing cessation (OR 2.87, 95% CI 2.28–3.60). Additionally, a derived obstructive sleep apnea score of 2–3 (OR 2.67, 95% CI 2.25–3.15) and cumulative sleep symptoms (>5) (OR 5.38, 95% CI 4.03–7.18) was associated with significantly increased odds of acute stroke, with a graded association observed for cumulative sleep symptoms. After adjusting for potential mediators, most of the symptoms maintained their significance, except for difficulty falling asleep and unplanned napping. Similar associations were observed across different stroke subtypes.

The study findings demonstrated the high prevalence of sleep disturbance symptoms and their association with an elevated risk of acute stroke. The symptoms may serve as indicators of individual risk or independent risk factors for stroke. Future clinical trials should investigate the effectiveness of sleep interventions in stroke prevention.

Source: n.neurology.org/content/100/21/e2191