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Odds of stroke increased with short or long duration of sleep, impaired sleep quality, snoring, snorting, breathing cessation

Sleep problems are associated with an increased risk for stroke, according to a study published online April 5 in Neurology.

Christine Eileen McCarthy, M.B., B.Ch., from the National University of Ireland in Galway, and colleagues examined the association between a spectrum of sleep disturbance symptoms and the risk for acute stroke in an international case-control study of patients presenting with first stroke and controls matched by age and sex (INTERSTROKE).

Data were included for 4,496 matched participants: 1,799 experienced an ischemic stroke and 439 had an intracerebral hemorrhage. The researchers found that in the primary model, the odds of acute stroke were increased in association with short sleep (less than five hours) and long sleep (more than nine hours; odds ratios, 3.15 and 2.67, respectively), impaired quality (odds ratio, 1.52), difficulty getting to sleep or maintaining sleep (odds ratios, 1.32 and 1.33, respectively), unplanned napping and prolonged napping (more than one hour; odds ratios, 1.59 and 1.88, respectively), snoring, snorting, and breathing cessation (odds ratios, 1.91, 2.64, and 2.87, respectively). Significantly increased odds of acute stroke were also seen in association with a derived Obstructive Sleep Apnea score of 2 to 3 (odds ratio, 2.67) and cumulative sleep symptoms (more than five: odds ratio, 5.06), with a graded association for the latter. For most symptoms, significance was maintained following extensive adjustment; similar findings were seen for stroke subtypes.

“With these results, doctors could have earlier conversations with people who are having sleep problems,” McCarthy said in a statement. “Interventions to improve sleep may also reduce the risk of stroke and should be the subject of future research.”

The INTERSTROKE study was partially funded by grants from several pharmaceutical companies.

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