Short Sleep May Signal Stroke Risk

By*Ed Susman, Contributing Writer, MedPage Today

Published: June 12, 2012

Reviewed*by*Zalman S. Agus, MD; Emeritus Professor, Perelman School
of Medicine at the University of Pennsylvania and Dorothy Caputo, MA,
BSN, RN, Nurse Planner

This study was published as an abstract and presented at a conference.
These data and conclusions should be considered to be preliminary until
published in a peer-reviewed journal.

In this study, chronically sleeping less than 6 hours per night
significantly increased the rate of stroke symptoms among middle-age to
older individuals of normal weight who had low risk of sleep-disordered

BOSTON – People who habitually sleep less than 6 hours appear to be at
risk of developing symptoms that may predict future stroke, researchers
reported here at the annual meeting of the Associated Professional Sleep

Study participants with normal body mass indices (BMIs) who slept less
than 6 hours a night had a 4.5-fold increased risk of having a
stroke-like symptom compared with similar individuals who got 8 to 9
hours of sleep a night (P=0.002), Megan Ruiter, PhD, a postdoctoral
fellow at the University of Alabama at Birmingham, said in an oral

"We think our study should alert physicians that they should screen
their patients for sleep problems," said Ruiter.

The research involved 5,666 patients who participated in the long-term
Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.
Participants were asked if they had experienced any stroke-like
symptoms: painless hemibody weakness, painless hemibody numbness, loss
of vision in one or both eyes, loss of hemifield vision, inability to
understand or the inability to express oneself in words or in writing.

"All of these signs are significant independent predictors of future
stroke events," Ruiter said.
In all, 244 individuals reported at least one of the stroke symptoms
during about a 2- to 3-year follow-up. In the initial univariate
analysis, short sleep was observed as one risk factor for stroke
symptoms, but significance of that disappeared in the multivariate
analysis, she said.

The researchers did observe that body mass index remained as a
significant (P=0.047) factor in risk of stroke symptoms, but short sleep
and body mass index were only risk factors in normal-BMI individuals.
Ruiter said her research team could not find a relationship between BMI
for overweight or obese individuals and a link to habitual sleep

"In employed, middle-age to older adults relatively free of major risk
factors for stroke such as obesity and sleep-disordered breathing, short
sleep duration may exact its own negative influence on stroke
development," said Megan Ruiter. "We speculate that short sleep duration
is a precursor to other traditional stroke risk factors, and once these
traditional stroke risk factors are present, then perhaps they become
stronger risk factors than sleep duration alone."

She suggested that because normal-weight individuals are not at high
risk of having sleep problems, physicians may not ask about sleep
duration in this population.

"The factor that is missing from this analysis is whether the
individuals are sleeping less because they have difficulty falling
asleep or because they choose to sleep less," Daniel Cohen, MD, a
private practice neurologist from Norfolk, Va., who moderated the
session, told MedPage Today. "That could make a difference in these

The participants that Ruiter and colleagues scrutinized had no baseline
history of stroke, transient ischemic attack, or stroke symptoms, and
did not have a high risk for obstructive sleep apnea at the start of the

Researchers recorded the first stroke symptoms, along with demographic
information, stroke risk factors, depression symptoms, and various
health behaviors.

The average age of the participants was 61 years, about 44% of the
cohort were men, and about 33% were African Americans. Most of the
individuals in the study were employed.

"Sleep and sleep-related behaviors are highly modifiable with
cognitive-behavioral therapy approaches and/or pharmaceutical
interventions," Ruiter said. "These results may serve as a preliminary
basis for using sleep treatments to prevent the development of stroke."

The study was funded by the National Institute of Neurological Disorders
and Stroke.

Ruiter had no disclosures. Cohen had no disclosures.

From the American Heart Association:
Guidelines for the Primary Prevention of Stroke
AHA Science News from EPI/NPAM 2011: Gender Modifies the Association
between Sleep Habits and Cardiovascular Disease Risk Factors

Primary source: Associated Professional Sleep Societies

Source reference:
Ruiter M, et al "Short sleep predicts stroke symptoms in persons of
normal weight" APSS 2012; Abstract 0829.

Donna G.

1) Rejoice always, Pray continually, Give thanks in all circumstances,
For this is God's will for you in Christ Jesus. ( I Thessalonians
5:16-18 NIV )

2) ANGELS EXIST, but some times, since they don't all have wings, we
call them FRIENDS......

3) Just because you're in pain, doesn't mean you have to be one!