Article Impact Level: HIGH Data Quality: STRONG Summary of Stroke, 55(3). https://doi.org/10.1161/STR.0000000000000453 Dr. Rebecca F. Gottesman et al.
Points
- Disrupted sleep is associated with an increased risk of stroke, subclinical cerebrovascular damage, and dementia.
- Individuals with sleep apnea have a higher likelihood of experiencing stroke, which can lead to long-term cognitive impairment.
- Positional OSA occurs mainly when sleeping on the back, and side-sleeping may help reduce apnea episodes and lower stroke risk.
- Up to 34% of middle-aged men and 17% of middle-aged women may have sleep apnea, with many cases going undiagnosed.
- The study highlights sleep disorders as modifiable risk factors and suggests simple interventions like adjusting sleep position could improve outcomes and reduce stroke risk.
Summary
This study investigates the link between sleep disorders, particularly sleep-disordered breathing like obstructive sleep apnea (OSA), and its potential effects on brain health, including stroke and dementia. It discusses how sleep disorders are becoming increasingly recognized as risk factors for various chronic diseases, with implications for both cardiovascular and cognitive outcomes. The study emphasizes that disrupted sleep, including sleep fragmentation and variations in sleep duration, is associated with an increased risk of stroke, subclinical cerebrovascular damage, and dementia. Specifically, the relationship between OSA and stroke is highlighted, where individuals with sleep apnea face a higher risk of stroke. This major cardiovascular event often results in long-term cognitive impairment.
The authors also address the growing evidence of how sleep position may affect the severity of sleep apnea, particularly in people with positional obstructive sleep apnea, where apnea episodes occur primarily when individuals sleep on their backs. Data suggest that sleeping on the side may reduce apnea severity in some individuals, improving sleep quality and reducing stroke risk. The study reveals that up to 34% of middle-aged men and 17% of middle-aged women may be affected by sleep apnea, with many cases going undiagnosed. Furthermore, findings from clinical trials support the potential benefits of encouraging side-sleeping to mitigate the risks associated with OSA. However, further research is needed to confirm whether this approach can reduce long-term stroke risk.
The review concludes by reinforcing the importance of sleep in overall health, particularly for older adults and individuals with cardiovascular and neurological risks. It suggests that sleep disorders are an underappreciated modifiable risk factor and advocates for better recognition and management of sleep apnea. The study also highlights the role of simple interventions, like altering sleep position, which may significantly improve sleep apnea symptoms and potentially reduce stroke risks. Further research is needed to determine the best strategies for integrating sleep disorder management into stroke prevention and brain health strategies.
Link to the article: https://www.ahajournals.org/doi/10.1161/STR.0000000000000453
References Gottesman, R. F., Lutsey, P. L., Benveniste, H., Brown, D. L., Full, K. M., Lee, J.-M., Osorio, R. S., Pase, M. P., Redeker, N. S., Redline, S., Spira, A. P., & on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; and Council on Hypertension. (2024). Impact of sleep disorders and disturbed sleep on brain health: A scientific statement from the american heart association. Stroke, 55(3). https://doi.org/10.1161/STR.0000000000000453
