People with 5 or more symptoms of insomnia have 50% increased stroke risk

Of the more than 30,000 participants, 2,101 strokes were reported

ISLAMABAD, (Online) - A new study, published in the research journal Neurology, has found that symptoms of insomnia may significantly increase your risk of stroke, especially if you are below the age of 50.

Dr. Wendemi Sawadogo of Virginia Commonwealth University, one of the authors of the study, said insomnia’s link to stroke risk exists within a broader understanding of how it can also lead to other conditions.

“Insomnia symptoms can increase your risk of having diabetes, for example, hypertension, dyslipidemia, and those conditions can potentially be a risk factor of stroke so when we know that we can look at the connections [between stroke and insomnia] that are there,” Sawadogo said.

What the study found

The research pulled data from the Health and Retirement Study, a data set that allowed them access to 31,126 people with a broad range of lived experiences. The data collected ranged from 2002 to 2020, the average age of participants was 61, and the mean follow-up time for participants was nine years. Of the more than 30,000 participants, 2,101 strokes were reported.

Those studied were sorted into nine groups for analysis based on self-reported symptoms of insomnia.

On this scale, each new symptom meant a 7% increase in stroke risk.

People with five to six symptoms of insomnia were up to 51% more likely to have a stroke during the study period.

Dr. Johanna Fifi, vice president of the Society of NeuroInterventional Surgery and physician and professor at Mount Sinai, says that the study’s finding that those under 50 were at an increased risk makes sense to her as someone who treats stroke patients as part of her practice. She says that this difference in data could be because of the number of comorbidities older adults tend to be managing as well as younger people’s perceptions of their own health.

“Incidences of stroke increase as you get older, the incidence of insomnia also increases as you get older. So it may be hard to tease out the association of insomnia and stroke, once you’re older.”

Talk to your physician if you have insomnia

Aside from the increased risk, another key finding was that the risk was sustained over a long period of time, suggesting that this interconnected risk is unlikely to resolve itself on its own. Sawadogo says that people need to be aware of the many courses of action they can take rather than staying quiet about their symptoms.

“People who tend to have high symptoms keep reporting high symptoms over time so that’s another way to emphasize on the fact that people should be aware of their symptoms, it is not potentially going to go away if you don’t pay attention or take care of that.”

In the questionnaire which informed the data used, participants were asked questions about how challenging they found it to fall asleep, stay asleep, whether they woke up early, and whether they found their sleep to be “restorative.”

Fifi says that while her patients do tend to talk to her about their levels of sleep and any disruption, this may be because they’re already discussing their overall neurologic function with her. She says that sleep being considered as a more formal risk factor for stroke means understanding sleep as part of a wider care team for those at risk, particularly those with primary insomnia.

“I typically ask them to see their PCP first, their primary care physician. And then from there, they’ll see a sleep specialist. At that point, you’re looking at medications.”

Azizi Seixas, associate director of the Center for Translational Sleep and Circadian Sciences at the University of Miami., also stresses the need to communicate with your care team. However, he says that a lot of the value that stems from research like this is how it can inform further diagnosis, treatment, and prevention.

“What it allows us to do… is finding more tailored, personalized risk profiles as to who might be more at risk for certain health conditions. Whether it be a combination of a sleep disorder or their [sleep] duration, or the lack of efficiency, or the lack of satisfaction, or feeling rested. And to see which of those profiles or sleep risk profiles confers adverse health outcomes.”

Prioritizing sleep

Fifi believes that despite the research’s already stated limitations, including how reliance on self-reported symptoms can lead to challenges, this research does add to the significant body of work that is now being contributed when it comes to the effects of lack of sleep. She says that while stroke can be a heavy topic when it comes to your health as you age, there are some positives to draw from this new information.

“I think that there’s a silver lining in that there are treatments for insomnia which can, potentially therefore, reduce the risk of stroke.”

That’s the exact advice that the authors of the study, all of whom are affiliated with VCU, suggest could be a path forward. In their words, “Increased awareness and management of insomnia symptoms may contribute to the prevention of stroke occurrence.”

Seixas, meanwhile, is more blunt.

“We live in a culture where the lack of sleep and being able to be productive without much sleep is revered. And unfortunately, what the study highlights is that you only have that for a certain period of time. Because something ominous might unfortunately be waiting , such as a stroke. if you don’t address your sleep problems.”