New Study Suggests Symptoms of Insomnia Linked to Increased Risk of Stroke

A new study suggests that insomnia symptoms are linked to a greater risk of stroke, especially in people under 50 years of age, according to research published in Neurology. The risk of stroke was 4-fold in patients under 50 years of age who had a higher number of symptoms of insomnia.

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“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 behavioral therapies for people who are having trouble sleeping and possibly reducing their risk of stroke later in life,” said study author Wendemi Sawadogo, MD, MPH, PhD, Virginia Commonwealth University, Richmond, Virginia, and member of the American Academy of Neurology, in a recent press release.

People with 1 to 4 (less severe) symptoms of insomnia still had a 16% increased risk of stroke compared to people with no symptoms after adjusting for age, alcohol use, smoking, and level of physical activity.

Investigators conducted a study to understand the link between the symptoms of insomnia and risk of stroke. The study included 31,126 people (average age 61 years) who had no history of stroke at the study onset. Patients answered questions about how frequently they had trouble:

• Falling asleep.
• Waking up during the night.
• Waking up too early and not being able to return to sleep.
• Feeling rested in the morning.

They responded to these questions with “most of the time,” “sometimes,” or “rarely or never,” and were followed for 9 years. Investigators judged the severity of symptoms on a scale of 1 to 8 (more severe).

Among participants, 6282 patients had no insomnia symptoms, 19,149 had 1 to 4 symptoms, and 5695 people had 5 to 8 symptoms. The results showed that 365 people without symptoms, 1300 people with 1 to 4 symptoms, and 436 with 5 to 8 symptoms suffered from stroke.

In addition, people who reported having 5 to 8 symptoms of insomnia had a 51% higher risk of stroke. Among people under 50 years of age who had 5 to 8 symptoms, approximately 6% suffered from stroke during the 9-year follow-up. Approximately 5% of people 50 years of age and older with the same number of symptoms suffered from stroke. However, people aged 50 years or older with 5 to 8 symptoms still had a large (38%) increased risk of stroke compared to people with no symptoms.

“This difference in risk between these 2 age groups may be explained by the higher occurrence of stroke at an older age,” Sawadogo said in the press release. “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.”

Further, people with diabetes, hypertension, heart disease, and depression had a higher risk of stroke. Although patient responses were self-reported and are at risk of inaccuracies, the data suggest there is an association between the conditions, according to the investigators.

Sawadogo surmises that “managing insomnia symptoms at a younger age may be an effective strategy for stroke prevention. Future research should explore the reduction of stroke risk through management of sleeping problems.”

Reference

American Academy of Neurology. Trouble falling asleep, staying asleep linked to increased risk of stroke. June 7, 2023. Accessed on June 8, 2023. https://www.eurekalert.org/news-releases/991195