Anyone who suffers from insomnia knows that it can be difficult to get through the day. But sleep disorders can do more than leave you groggy: They can also increase your risk of having a stroke, new research suggests.
The review, published in Sleep medicine reviewsanalyzed data from a total of 1.3 million participants from six previous studies examining risk factors for stroke, workplace injuries and hospitalizations. Researchers found that people with insomnia had a 26% higher risk of stroke and a 28% higher risk of being hospitalized for any reason.
The link between insomnia and stroke may seem random, but doctors say it makes sense. “Sleep affects many aspects of health and well-being and should be taken seriously,” says Beth Malow, MD., neurologist and chief of the Division of Sleep Disorders at Vanderbilt Health.
But the association between the two conditions is probably more complicated than it seems, according to W. Christopher Winter, MD., neurologist and sleep doctor at Charlottesville Neurology and Sleep Medicine. Here’s why.
Meet the experts: Beth Malow, MD., neurologist and chief of the Division of Sleep Disorders at Vanderbilt Health; W. Christopher Winter, MD., neurologist and sleep doctor at Charlottesville Neurology and Sleep Medicine; Christophe Yi, MD., vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, California
What’s behind the link?
This is not the first body of research to find an association between insomnia and a higher risk of stroke. A 2023 Neurology Analysis of data from 31,126 adults concluded that those who reported symptoms of insomnia were more likely to suffer a stroke during the nine-year follow-up – and the link was particularly strong in adults under 50.
Insomnia, which is defined because difficulty falling asleep, staying asleep, or getting quality sleep three or more nights a week can increase the risk of stroke in different ways, doctors say. “Sleep disruptions contribute to inflammation, increased blood clots, and other factors that can lead to stroke,” says Dr. Malow.
Poor sleep also increases your body’s release of the stress hormone cortisol, according to Christophe Yi, MD., a vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, California. Over time, this can contribute to increased blood pressure, increased heart rate and more, he says. “These changes can promote (plaque buildup in the arteries) and potentially increase the risk of heart attacks and strokes,” says Dr. Yi.
Insomnia can also negatively affect your metabolism, increasing your chances of weight gain, diabetes, and high cholesterol, all of which are risk factors for stroke, according to Dr. Yi.
But the link between insomnia and stroke could go both ways, according to Dr. Winter. “People predisposed to having a stroke are very predisposed to experiencing insomnia or conditions that interfere with sleep quality and regularity,” he says. “The opposite is also true: insomnia predisposes to cardiovascular disease and stroke, especially since “insomnia” is often a poorly defined term and almost a substitute for “poor sleep.”
There are many treatments available for insomnia
Although the study did not examine whether treating insomnia could reduce risk of stroke, doctors say that taking care of your sleep can help reduce your chances of developing some of the risk factors for stroke. Basically, insomnia should be treated, not ignored.
Insomnia can be treated in different ways, including improving sleep hygiene, taking certain medications and undergoing cognitive behavioral therapy, according to the study. National Heart, Lung, and Blood Institute (NHLBI).
But proper treatment for insomnia often involves looking at what’s fueling sleep deprivation, Dr. Winter says, noting that insomnia can be a symptom and a diagnosis. In some cases, a physical reason contributes. “When insomnia is a symptom, we determine what the underlying disorder is (sleep apnea, medication effect, anxiety, restless legs) and treat the disorder,” says Dr. Winter.
In others, when insomnia is the diagnosis, doctors will often use cognitive behavioral therapy for insomnia (CBT-I) to understand the feelings and beliefs that affect sleep, he explains. In fact, it is often considered the gold standard for treating insomnia.
“CBT-I can be very helpful because it addresses a wide range of treatment options and also helps patients change their beliefs about sleep,” says Dr. Malow. “For example, ‘If I don’t sleep well tonight, I’ll have a terrible day tomorrow,’ which can make insomnia even worse.”
When to See a Sleep Specialist for Insomnia
If you’re having trouble sleeping and your situation isn’t improving despite making some sleep hygiene changes, doctors say it’s time to consult a healthcare professional for next steps. “Contact your primary care provider or see a sleep specialist for more support,” says Dr. Malow. “A sleep specialist can also make sure there is no medical reason, such as obstructive sleep apnea, for your insomnia.”
Dr. Winter recommends taking action as soon as possible. “Early is better,” he says. “Insomnia and cardiovascular disease are easier to manage early in the process.”
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