As you get older, do you ever feel more aware of your health? Maybe you think about things like “Should I choose the salad instead of the burger?”
“Did I remember to get my flu shot?”
“Should I be worried about these symptoms?”
If you’ve been thinking about that last one, it’s very important that you don’t ignore any worrisome symptoms. They could be a sign of some very dangerous health problems, like strokes. 15 million people suffer from strokes worldwide each year. 5 million of these people will live with a disability afterward— and almost 6 million will die as a result of a stroke.
We’d like to shine a light on this serious health concern because it’s connected to another serious condition and many are unaware of the connection— sleep apnea.
Before we talk about the connection between sleep apnea and stroke risk, it’s helpful to define what a stroke is and how to identify when you’re having one. It could save a life!
If you already know the signs of a stroke, you can jump down to the section about how to reduce your stroke risk with a good night’s sleep here.
What is a Stroke?
A stroke occurs when the blood flow to your brain is disrupted.
Strokes are not only one of the leading causes of death and disability in America— they’re one of the leading causes of death worldwide.
That’s why it’s so important to not only treat strokes properly but also to know the warning signs and how to prevent them. Prompt and thorough medical attention can increase the odds of a more positive stroke outcome and survival.
What Causes a Stroke?
There are two main types of strokes based on what causes them.
- Ischemic stroke: Caused by a blockage preventing blood flow to your brain. This can be caused by blood clots or plaque build-up in your blood vessels.
- Hemorrhagic stroke: Caused by blood leaking or hemorrhaging in your brain. This is caused by a burst blood vessel in your brain.
What are Mini-Strokes?
It’s possible to experience stroke symptoms that go away after a few minutes. When this happens, it’s called a transient ischemic attack (TIA)— or a mini-stroke.
Even though these attacks are brief and the symptoms disappear quickly, it’s still vital to seek medical attention as soon as possible. Strokes and mini-strokes can cause brain cells to die within minutes because they’re deprived of vital oxygen to keep your body functioning.
What Are The Signs of a Stroke?
Strokes are accompanied by a few distinctive symptoms. By knowing these symptoms, it’s much easier to help stroke patients get the timely medical attention they need to make a full recovery. Even an acute stroke can cause permanent damage to the brain and body.
Stroke symptoms to be aware of are:
- Sudden numbness or weakness in your arm, face, or leg— often on one side of your body.
- Sudden confusion, difficulty speaking, or understanding speech.
- Difficulty seeing out of one or both eyes.
- Sudden, severe headache without a known cause.
- Sudden loss of balance, dizziness, loss of coordination, or difficulty walking.
When it comes to helping a stroke victim, it’s important to act quickly. Or, to act F.A.S.T., according to the Centers for Disease Control. If you believe that someone you know is having a stroke, use this acronym to get the urgent treatment they need.
- F (Face): Ask the person to smile. If one side of their face droops, they are experiencing a stroke.
- A (Arms): Ask them to raise their arms over their head. If one drifts downward, it is a sign of a stroke.
- S (Speech): Ask the person to repeat a simple phrase back to you. If their speech is slurred or difficult to understand, that is another sign of a stroke.
- T (Time): Time is of the essence. If you see any of the above signs, call 911 immediately.
Another way to determine a possible stroke— as well as its severity— is to use the National Institute of Health’s Stroke Scale.
Unfortunately, it’s not always easy to tell if someone is having a stroke because many strokes occur when they are unlikely to be caught by others.
Can You Have A Stroke in Your Sleep?
Yes— and it’s more likely to occur than you may expect. In fact, anywhere between 14 and 44 percent of strokes occur while the person is sleeping.
If a stroke victim experiences their symptoms during the night, it’s possible for their symptoms to wake them up. This is called a wake-up stroke.
Even if a person wakes up following their stroke, they’re more likely to have a poorer outcome from their stroke because they are less likely to get the prompt treatment they need to make a full recovery.
Stroke Risk Factors
There are many risk factors that can make you more likely to suffer a stroke. Some of these include:
- Age— Strokes can occur at any age, but older adults are at higher risk for having one.
- High blood pressure— or hypertension.
- Diabetes.
- Heart disease or heart failure.
- Atrial fibrillation— irregular and often rapid heart rhythm that can cause blood clots in your heart.
- High cholesterol.
- Transient ischemic attacks (TIA).
- Cancer.
- Sickle cell anemia.
- Sleep-disordered breathing— such as snoring
- Obstructive sleep apnea.
If you’re reading this article, then you’re probably familiar with sleep apnea and its dangers. Obstructive sleep apnea is a very serious and potentially life-threatening sleep disorder. It can both cause and worsen many health conditions, many of which are risk factors for strokes. But not only is obstructive sleep apnea a serious risk factor for a stroke— it may actually be a direct trigger.
The Connection Between Sleep Apnea and Stroke
According to a study published by the American Heart Association Stroke journal, sleep apnea and sleep-disordered breathing significantly increase stroke risk. This study observed two patients— both overweight senior women with sleep apnea. During the observation period, both patients woke up during the night following an acute stroke or TIA. Both also experienced significant periods of low oxygen saturation in their blood during REM sleep.
According to a study published by the Journal of the Missouri State Medical Association, sleep disorders— including sleep apnea, sleep-disordered breathing, hypersomnia, and insomnia— are closely connected to stroke risk. This study also found that specific patterns occurred in stroke patients with sleep apnea.
20 to 40 percent of ischemic strokes took place at night, most often right at sleep onset. A subset of these strokes— cryptogenic strokes— have been associated with sleep-disordered breathing. As a result, sleep-disordered breathing is a suspected trigger for between 50 and 70 percent of strokes that happen at night. In addition to that, stroke patients that have had multiple events are more likely to have sleep-disordered breathing than someone who has experienced a single stroke.
Pre-existing sleep disorders can increase your stroke risk— and acute strokes can potentially cause sleep-disordered breathing.
How Does Sleep Apnea Lead to a Stroke?
More research is needed to know for sure, but there are a few contributing factors that experts believe are potential triggers. These include:
- Changes in airway pressure due to apneas or hypopneas.
- Intermittent hypoxemia— low oxygen levels in the blood.
- Endothelial dysfunction— the blood vessels in your heart constrict instead of expand, often as a response to heart trouble.
- Sympathetic activation— your heart working too hard to move blood and oxygen through your body.
If you experience severe sleep apnea, these triggers can put you at an increased risk of stroke. These risk factors are also red flags for your cardiovascular health.
One of the best ways to help reduce your risk for heart disease and stroke would be to get a good night’s sleep. Unfortunately, this is often easier said than done for millions of Americans suffering from poor sleep and sleep disorders.
Related: Sleep Apnea Doubles Risk for Sudden Cardiac Death
Can Sleeping Too Much Cause a Stroke?
It can. Excessive sleep can be a sneaky risk factor for many serious health disorders, including Alzheimer’s disease, cardiovascular disease, and stroke.
A study published by the journal Neurology found that there was an 85 percent higher stroke risk in people who slept for 9 or more hours each night, and napped during the day.
The study observed 31,750 participants for six years. On average, participants were approximately 62 years old and had no history of stroke or other serious health conditions when the study began.
When compared to those who slept 7-8 hours each night, long sleepers— 9 hours or more a night— had a 23 percent higher stroke risk. As mentioned above, long sleepers that napped were at an 85 percent higher stroke risk. On the other hand, shorter sleep— 6 hours or less a night— did not have a significant effect on stroke risk.
Long sleep wasn’t the only notable risk factor either. Participants who experienced poor sleep quality were also at a higher risk for strokes.
More research is needed to explore the connection further, but one thing is for sure— both insufficient sleep and excessive sleep can cause problems. So when it comes to a good night’s sleep, you want to keep the “Goldilocks Rule” in mind— don’t get too little, and don’t get too much. Get just the right amount— for most adults, that’s between 7-9 hours of quality sleep each night.
Related: 10 Causes of Excessive Sleep
How to Reduce Your Stroke Risk With a Good Night’s Sleep
Getting enough quality sleep each night shouldn’t be a chore. Here are a few of our suggestions to help you reduce your stroke risk and get the healthy sleep you need.
Practice Good Sleep Hygiene
Sleep hygiene is all the positive habits you can follow before you go to sleep each night. A few of these habits may include:
- Avoid alcohol at least 3 hours before bedtime, and caffeine for at least 6 hours.
- Stop using electronic devices at least an hour before bed. The blue light from these devices prevents your body from producing the melatonin you need for a good night’s sleep.
- Give yourself enough time to finish your day’s tasks, and to relax afterward. Some great technology-free ways to relax can include meditation, journaling, spending time with family, reading a book, or taking a warm shower or bath.
- Go to bed at the same time every night, and wake up at the same time every morning. This gets your body into a routine and trains your body to be awake or asleep at the right times.
Get Tested for Sleep Disorders
Sleep disorders can be hard to catch. But the longer they’re left untreated, the more time they have to wreak havoc on your health. Untreated sleep apnea can especially put you at increased risk of diabetes, obesity, heart attack, and even erectile dysfunction.
If you or your bed partner show any of the following symptoms, contact your doctor or sleep expert as soon as possible:
- Extremely loud snoring, gasping or choking during sleep
- Pauses or stops in breathing during sleep
- Taking 30 minutes or more to fall asleep at night
- Waking up too early in the morning
- Daytime fatigue
- Feeling unrested— even after a full night’s sleep
If You Have Sleep Apnea, Follow Your CPAP Treatment
Sleep apnea won’t go away on its own. To help eliminate your sleep apnea symptoms, you need to seek the appropriate treatment.
CPAP— continuous positive airway pressure— is a highly effective obstructive sleep apnea treatment. CPAP treats sleep apnea by gently opening your airways, allowing you to breathe easily and sleep well thanks to a constant stream of gentle pressurized air.
Some sleep apnea patients stop using their CPAP treatment if they think the apparatus is bulky, uncomfortable, or even ineffective. However, CPAP treatment can only work if you stick to it.
If you believe that your CPAP therapy isn’t working or is uncomfortable, talk to your doctor or a sleep specialist. They can help you find an alternative treatment if necessary.
Don’t Risk Your Health With Poor Sleep
Sleep apnea and strokes are more closely related than you may have expected. Both are very serious on their own, but they can be a very dangerous and potentially dangerous combination.
Never ignore any sleep problems or health problems you may be experiencing— no matter how small they may seem. That extra care can potentially save your life.
Not sure if you have a sleep disorder? Contact us at the Sleep Centers of Middle Tennessee today. We can help you schedule an evaluation of your symptoms so you can get back to the good sleep and good health you deserve.
References
“Stroke Signs and Symptoms.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 Mar. 2022, www.cdc.gov/stroke/signs_symptoms.htm.
“NIH Stroke Scale/Score (NIHSS).” MDCalc, www.mdcalc.com/nih-stroke-scale-score-nihss.
Pressman, M R, et al. “Transient Ischemic Attacks and Minor Stroke during Sleep.” Stroke, 1 Dec. 1995, www.ahajournals.org/doi/10.1161/01.str.26.12.2361.
Hepburn, Madihah, et al. “Sleep Medicine: Stroke and Sleep.” Missouri Medicine, Journal of the Missouri State Medical Association, 2018, www.ncbi.nlm.nih.gov/pmc/articles/pmc6312177/.Zhou, Lue, et al. “Sleep Duration, Midday Napping, and Sleep Quality and Incident Stroke.” Neurology, Wolters Kluwer Health, Inc. on Behalf of the American Academy of Neurology, 28 Jan. 2020, n.neurology.org/content/94/4/e345.