A stroke, also known as a “brain attack” or cerebrovascular accident (CVA), occurs when the blood supply to the brain is compromised. A stroke occurs when there is low blood flow (ischemia), a blocked artery (thrombosis), or bleeding in the brain (intracerebral hemorrhage). Symptoms of a stroke can include slurred speech, difficulty communicating or understanding language, facial asymmetry, and arm or leg numbness or weakness. If the interruption in the blood supply is short and the symptoms resolve, the event is known as a transient ischemic attack (TIA). If the interruption in the blood supply is longer, damage to the brain can occur and lead to the death of brain cells and development of permanent focal neurological deficits such as aphasia, hemiparesis, or hemiplegia. Traditional risk factors for the development of stroke are similar to those for coronary artery disease, and include high blood pressure, diabetes, high cholesterol, and smoking. In addition, the heart arrhythmia known as atrial fibrillation is known to increase the risk of stroke dramatically. We have previously discussed the new anticoagulants that are used to prevent stroke in patients with atrial fibrillation. Researchers from the University of Alabama at Birmingham, lead by Dr. Megan Ruiter, have found that prolonged sleep deprivation can increase the risk of stroke in healthy low risk middle aged adults. The study results were presented at the annual meeting of the Associated Professional Sleep Societies in Boston, Massachusetts. The investigators used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The results were based on information obtained from 5,666 study participants aged 45 years or older who were followed for a three year period. The study participants were free of stroke, transient ischemic attack, neurological deficits, or sleep-disordered breathing at the time of enrollment in the study. In addition, the study participants had a normal body mass index, which means that they were not overweight or obese. The researchers found that the study participants that had six or less hours of sleep had four times the risk of developing stroke symptoms as compared to those study participants that had seven to eight hours of sleep each night. The results were adjusted for possible confounding factors that may have accounted for these results such as high blood pressure, high cholesterol, obesity, and sleep disordered breathing. Despite controlling for these other risk factors for stroke, the investigators still found an association between sleeping less than six hours during the night and the development of stroke symptoms. Physicians should use this information to counsel their patients on the importance of having a full night of sleep, and discuss the association of prolonged sleep deprivation with the occurrence of stroke. Future research should focus on the treatment of insomnia as a possible method to decrease the risk of stroke.
The REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study is funded by the National Institute of Neurological Disorders and Stroke.