The Link Between Insomnia and Stroke

People with insomnia, especially young adults, may have a higher risk of stroke than those without the sleep disorder, according to a study published in the American Heart Association journal, Stroke. Researchers analyzed the health records of more than 21,000 people with insomnia and 64,000 regular sleepers in Taiwan and found the link between insomnia and stroke was especially strong in people age 18 to 34, who were up to eight times more likely to suffer a stroke if they had insomnia.

“We’ve known for a long time that quality of sleep is directly related to medical conditions,” says preventive cardiologist Jonathan Fialkow, M.D., who serves as medical director of Clinical Cardiology at Miami Cardiac & Vascular Institute at Baptist Hospital and co-medical director of the hospital’s Chest Pain Center. “Sleep is very important to health and well-being, and sleep issues should be identified and treated earlier in clinical settings to prevent future disease risk.”

Stroke is the leading cause of long-term disability in the U.S. and the third-leading cause of death, according to the Centers for Disease Control and Prevention. Although statistics show nearly 75 percent of all strokes afflict people over the age of 66, Dr. Fialkow reminds patients that unhealthy habits in early adulthood affect their long-term cardiovascular health.  

In addition to poor sleep, other lifestyle factors such as diet, exercise, alcohol use, smoking and stress can influence the association between insomnia and stroke risk, experts say. The insomniacs in this study also tended to have additional health factors that increased their risk of stroke, including diabetes, obesity, high blood pressure and high cholesterol.

So, does insomnia increase these other risk factors, or does an unhealthy lifestyle that increases stroke risk cause people to suffer insomnia? It’s probably a little of both, Dr. Fialkow says.

“Insomnia often is a symptom of another disease or disorder that needs to be addressed,” he says.

Insomnia: Other Health Risks 

Among the conditions that can lead to insomnia are arthritis, heartburn, hyperthyroidism, restless leg syndrome, prostate and bladder issues, sleep apnea, obesity, anxiety and having a spouse who snores, says Jeffrey Horstmyer, M.D., a neurologist affiliated with Baptist Health South Florida and chairman of Neuroscience Center of Florida Foundation and Miami-Dade Stroke Consortium.

“If you’re experiencing persistent insomnia, it’s vital to determine the root of the problem,” Dr. Horstmyer says.  “A lot of healing occurs while you’re sleeping. While cells repair and rebuild at all stages of sleep, the majority of cell turnover and regeneration occurs during deep sleep.”

Deep-Sleep Health Perks

Sleep helps your body regulate blood pressure, metabolism and glucose levels, manage hormones and maintain a healthy immune system. REM sleep also is important for consolidating memory, says Dr. Horstmyer. If you’re not getting enough sleep, you may have trouble making decisions, solving problems, controlling your emotions and coping with stress, he explains. Sleep deficiency also has been linked to depression, suicide and risk-taking behavior.

Because sleep issues are prevalent and identifying and treating them is important, Drs. Fialkow and Horstmyer administer a sleep survey to all patients as part of their medical history and evaluation. In some cases, the sleep survey result prompts a referral to a sleep specialist; while in other cases, the survey may reveal poor sleep hygiene – practices and habits that can make the difference between restlessness and restful slumber.  

Healthy Sleep Tips

To get a good night’s rest, the National Sleep Foundation recommends following these healthy sleep hygiene tips

  • Maintain a stable bedtime and waking schedule.
  • Exercise regularly.
  • Avoid eating right before bedtime.
  • Avoid stimulants such as caffeine, nicotine and alcohol close to bedtime.
  • Increase exposure to natural light during the day to help maintain a healthy sleep-wake cycle.
  • Boost melatonin production at night by dimming lights and turning off your television and computer.
  • Avoid long naps and napping after 3 p.m.
  • Establish a regular relaxing bedtime routine, which may include taking a warm bath, reading or listening to calming music. 
  • Use your bedroom only for sleep. It may help to remove work materials, computers and televisions from your bedroom.
  • Create a good sleep environment – one that is quiet, dark and cool with a comfortable mattress and pillows.
  • Improved sleep habits can lead to better-quality sleep, which can help protect mental health, physical health and quality of life, Drs. Fialkow and Horstmyer say.

    “The take-away message from this study is to make sleep a priority,” Dr. Fialkow says. “Chronic insomnia at any age deserves a closer look and evaluation by a doctor.”


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