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Too Little Sleep Tied to Stroke Risk

By Steven Reinberg

HealthDay Reporter | HealthDay 4 mins 24 secs ago

MONDAY, June 11 (HealthDay News) -- Middle-aged and older people who regularly

sleep less than six hours a night may be significantly raising their risk of

stroke, a new study suggests.

As much as a fourfold increased risk was seen among normal-weight people who

didn't suffer from sleep apnea but got fewer than six hours of sleep each

night, the researchers found. Both obesity and sleep apnea are known risk

factors for stroke.

"Sleep is important," said lead researcher Megan Ruiter, a postdoctoral fellow

at the University of Alabama at Birmingham's School of Medicine. "There is

evidence that insufficient sleep ... increases all sorts of abnormal responses

in the body."

Lack of sleep increases inflammation and causes increases in blood pressure and

the release of certain hormones, all creating a greater stress response that

can increase the risk for stroke, Ruiter said.

The results of the study were scheduled to be presented Monday at the annual

meeting of the Associated Professional Sleep Societies in Boston. The data and

conclusions should be viewed as preliminary until published in a peer-reviewed

journal.

For the study, Ruiter's group collected data on more than 5,600 people who took

part in a larger study on geographical and racial differences in stroke.

Over three years of follow-up, the researchers found that sleeping fewer than

six hours a night was associated with an increased risk of stroke in

normal-weight people beyond that related to other risk factors.

They didn't find any association between stroke and short sleep among

overweight and obese people.

Although the study found an association between shorter sleep and stroke, it

did not prove a cause-and-effect relationship.

Dr. Michael Frankel, director of vascular neurology at Emory University and

director of the Marcus Stroke & Neuroscience Center at Grady Hospital, both in

Atlanta, commented that "although difficult to define why this may be

occurring, one can speculate about a possible mechanism linked to changes in

cortisol levels, an important stress hormone that may be in higher levels in

people who have shortened sleep."

Elevated levels of this hormone may trigger dysfunction of the cells that line

and protect people's blood vessels and set in motion the cascade of events that

leads to stroke, he explained.

This finding may explain why people without traditional vascular risk factors

such as obesity, hypertension and diabetes occasionally have a stroke, he

added.

"We know that in about a third of patients with ischemic stroke, doctors are

unable to define a cause," Frankel said. "Reduction in sleep may be

contributing in some of these patients."

"For those of us who chronically work long hours, we may need to listen closely

to these findings and adjust our lifestyle to reduce our risk of stroke," he

added.

Controlling blood pressure; eating a low-calorie, balanced diet; exercising;

not smoking; not drinking heavily; having regular checkups; and closely

following doctors' advice remain critical for vascular health, Frankel said.

"But attention to proper sleep may be equally important," he added.

Another expert, Dr. Keith Siller, medical director of the NYU Comprehensive

Stroke Care Center in New York City, agreed that sleep is an important factor.

"I see this as part of a general message that along with exercise and a proper

diet, a good night's sleep should be included in a healthy lifestyle," he said.