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By Jill Ross, HealthAtoZ contributing writer
If you sleep more than eight hours a night, snore and still feel sleepy during the day, that may be a wake-up call that you are at an increased risk for having a stroke.
Researchers at the State University of New York (SUNY) at Buffalo discovered a link between sleep disorders and stroke after studying 1,348 adults in a stroke screening program. Of the group, 6 percent had a previous stroke and 7 percent had a blocked carotid artery, the neck artery that supplies blood to the brain. Blockage of the carotid artery is a leading cause of stroke in Americans.
"The study demonstrated an association between sleep variables and stroke, independent of other risk factors, such as hypertension (high blood pressure), cigarette smoking, diabetes and high cholesterol," says the study's lead author, Adnan I. Qureshi, M.D., assistant professor of neurosurgery at SUNY at Buffalo. "Individuals who snore severely or have trouble staying awake during the day should see a doctor to find out why."
The sleep connection
Sleep apnea, a disorder characterized by heavy snoring, has been recognized as a contributor to heart disease as well as stroke. Sleep apnea, a condition in which breathing stops briefly and repeatedly during sleep, strains the cardiovascular system and can cause an increase in blood pressure.
Stroke is the third-leading cause of death in the United States after cancer and heart disease. Each year about 700,000 people have a new or recurrent stroke. About 500,000 are first attacks, and 200,000 are recurrent attacks. Stroke accounted for 162,672 deaths in 2002 and 942,000 hospital discharges, according to the American Stroke Association.
A stroke occurs when blood flow to the brain is blocked either because of narrowed blood vessels or blood clots or when there is bleeding in the brain. When that occurs, brain nerve cells begin to die within minutes. The result can be vision and sensory loss, problems with walking and talking or difficulty in thinking clearly.
Specifically, Qureshi and his team found the frequency of prior stroke or stroke-like events called transient ischemic attacks (TIAs) was 14 percent among those who reported routinely sleeping eight hours or more a night. The frequency was 5.4 percent among those who slept for six to eight hours and 5.4 percent for those who slept less than six hours.
Of adults who reported daytime drowsiness, 14 percent had suffered a stroke or TIA, compared with 4 percent of those who remained alert during the day.
The study essentially supported what Qureshi and colleagues found in an earlier study using federal health data on 7,844 men and women. In that study, people who reported longer sleep and daytime drowsiness were twice as likely to suffer a stroke during a 10-year follow-up period than those who didn't sleep enough or have daytime drowsiness.
"The studies point to important health consequences of sleep," Qureshi says. "People have always recognized the importance of sleep, and there is enough evidence in lab experiments to show that if you don't have enough adequate sleep, it does impact daytime functioning and may have other health consequences."
Reducing your risk
In addition to getting sleep disorders evaluated, Qureshi says there are other lifestyle changes you can make to reduce your stroke risk.
- Control your blood pressure. High blood pressure, also called hypertension, is, by far, the most potent risk factor for stroke. Have your blood pressure checked often. If it is high, follow your doctor's advice on how to lower it. Experts say keep a healthy weight, avoid drugs known to raise blood pressure, cut down on salt, and eat fruits and vegetables to increase potassium in your diet.
- Stop smoking. Cigarette smoking is linked to the buildup of fatty substances in the carotid artery. Also, nicotine raises blood pressure; carbon monoxide reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood more likely to clot.
- Exercise regularly. Researchers think that exercise may make the heart stronger and improve circulation. It also helps control weight. Being overweight increases the chance of high blood pressure, atherosclerosis (hardening of the arteries), coronary heart disease and type 2 diabetes. Talk to your doctor before starting an exercise program.
- Eat a healthy diet. Eat foods low in fats, saturated fats and cholesterol, and eat a variety of fruits and vegetables.
- Control your diabetes. Diabetes can damage the blood vessels throughout the body and lead to atherosclerosis.
What if you have a stroke?
Call 911 immediately. The warning signs of stroke are:
- Sudden numbness or weakness of face, arm or leg, particularly on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Research by Qureshi and his colleagues on the association of sleep disorders and stroke was presented at the American Stroke Association's 26th International Stroke Conference.
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External Sources
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National Institute of Neurological Disorders and Stroke
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The American Stroke Association
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State University of New York (SUNY)
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This article was reviewed and updated June 2007.
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