Insomnia? Oversleeping? Both may increase your risk of stroke

There is growing evidence that sleep disorders like insomnia and sleep apnea are related to stroke risk and recovery from stroke, according to a recent literature review. The review is published in the August 3, 2016, online issue of Neurology, the medical journal of the American Academy of Neurology.

Based on the review, the authors recommend that people who have had a stroke or a mini-stroke, called a transient ischemic attack, be screened for sleep disorders.

"Although sleep disorders are common after a stroke, very few stroke patients are tested for them," said study author Dirk M. Hermann, MD, of University Hospital Essen in Essen, Germany. "The results of our review show that should change, as people with sleep disorders may be more likely to have another stroke or other negative outcomes than people without sleep problems, such as having to go to a nursing home after leaving the hospital."

The researchers also recommend that sleep apnea be treated with a continuous positive airway pressure machine (CPAP), based on evidence that shows that its use can improve outcomes after stroke.

For the literature review, the researchers examined dozens of studies that looked at the link between sleep disturbances and stroke. They then combined the data of multiple studies in a meta-analysis.

Sleep disorders generally fall into two categories: sleep breathing problems and sleep-wake disorders. Sleep breathing problems like sleep apnea disrupt breathing while asleep. Sleep-wake disorders like insomnia and restless leg syndrome affect the amount of time spent asleep.

The review found evidence linking sleep breathing problems with stroke risk and recovery. Sleep-wake disorders may increase stroke risk and harm recovery, although there is less evidence to prove so.

Due to this lack of evidence and to possible side effects, the researchers are cautious to recommend treatment of sleep-wake disorders with drugs.