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Insomnia increases stroke risk

A new study has reported a serious risk associated with stroke, particularly among young adults: stroke
A new study has reported a serious risk associated with stroke, particularly among young adults: stroke
Robin Wulffson, MD

Some individuals occasionally experience insomnia, while some experience it frequently. A new study has reported a serious risk associated with stroke, particularly among young adults: stroke. The findings were published online on April 3 in the journal Stroke by Taiwanese researchers.

The study authors note that the medical literature lacks studies evaluating the impact of insomnia on stroke. Therefore, they conducted a study to examine insomnia in relation to subsequent stroke during a four year follow-up period.

The investigators accessed data from the Taiwan National Health Insurance Research Database. Individuals with International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for insomnia were compared to randomly selected, age- and sex-matched individuals who did not have a diagnosis of insomnia. The study included 21,438 (average age: 52 ± 16 years) insomniacs and 64,314 matched non-insomniacs (average age, 51 ± 16 years). Hospitalization of both groups for stroke were tallied during the four year follow-up period. None of the subjects in either group did not have a previous diagnosis of stroke, sleep apnea, or insomnia. Individuals with insomnia were further categorized into subgroups based on their insomnia patterns; this was done to determine whether the risk of stroke varied by subtype. The data was subjected to statistical analysis and the impact of insomnia was estimated.

The investigators found that, compared to non-insomniacs, insomniacs had a 54% higher risk of suffering a stroke (1.54-fold increased risk). When the data was segregated into insomnia subgroups, the persistent insomniacs had a higher three year cumulative incidence rate of stroke, compared to those in the remission group. The insomniacs-to-non-insomniacs incidence rate ratio for stroke was highest among individuals aged 18 to 34 years (8.06-fold increased risk). The researchers suggested a reason for the association of stroke risk and insomnia. They theorized that insomnia may lead to systemic inflammation, impaired glucose tolerance, and increased blood pressure; thus, altering cardiovascular health that could possibly result in a stroke.

The authors concluded that insomnia predisposes individuals to increased risk of stroke’ furthermore, this association is intense among young adults. They noted that their findings results underscore the clinical importance of identifying and treating insomnia. They recommended that new behavioral intervention methods that focus on insomnia should be developed, which might reduce or prevent stroke risk, particularly for young adults who have a profound risk.

In addition to insomnia, several conditions and certain lifestyle choices increase a person’s risk of a stroke: The major risk factors are: high blood pressure, heart disease, diabetes, cigarette smoking, and prior stroke.