Having Sleep-Wake Disturbances May Lead to More Cerebrocardiovascular Events in Stroke Survivors

A clinical study found that stroke survivors  who had from sleep-wake disturbances are more likely to have another stroke or serious cardiovascular or cerebrovascular event than those who do not experience those disturbances.

The study results suggest that stroke survivors with 1 subsequent cardio-cerebrovascular event have a higher sleep burden index score than those without a subsequent event 3 months to 2 years after their stroke (Wilcoxon rank-sum test P<.01). A high sleep burden index was associated with a higher risk for subsequent cerebro-cardiovascular events (Odds Ratio = 2.10 per index unit, 95% CI:1.34-3.30, P<.01).    

The study found that multiple sleep-wake disturbances such as sleep-disordered breathing, extremely long or short sleep duration, insomnia, or restless leg syndrome increased the risk of a cardiovascular or cerebrovascular event in the 2 years following a stroke. 

This finding suggests that assessing and improving sleep patterns in stroke survivors could improve their long-term outcomes. 

In this study, people who had an ischemic stroke or transient ischemic attack (n=438, mean age 65), had sleep-disordered breathing assessed with respirography. The presence and severity of sleep-wake disturbances such as insomnia, restless leg syndrome, and poor sleep duration, as well as daytime symptoms such as sleepiness, were recorded for each participant at 1, 3, 12, and 24 months after their stroke. The occurrence of new cardio-cerebrovascular events was recorded during 2 years of follow up.

“We know that people who have had a stroke often experience sleep disorders and that these are associated with worse stroke recovery outcomes,” stated Martijn Dekkers and Simone Duss, University of Bern in Switzerland. “What we wanted to learn from this study was whether sleep-wake disturbances, in particular, are associated with worse outcomes after stroke.”