Sleep disorders as both risk factors for, and a consequence of, stroke: A narrative review

Abstract

Background and purpose Sleep disorders are increasingly implicated as risk factors for stroke, as well as a determinant of stroke outcome. They can also occur secondary to the stroke itself. In this review we describe the variety of different sleep disorders associated with stroke, and analyze their effect on stroke risk and outcome. Methods A search term-based literature review (“sleep”, “insomnia”, “narcolepsy”, “restless legs syndrome”, “periodic limb movements during sleep”, “excessive daytime sleepiness” AND “stroke” OR “cerebrovascular” in PubMed; “stroke” and “sleep” in ClinicalTrials.gov) was performed. English articles from 1990 to March 2023 were considered. Results Increasing evidence suggests that sleep disorders are risk factors for stroke. In addition, sleep disturbance has been reported in half of all stroke sufferers; specifically an increase in not only sleep-related breathing disorders, but also periodic limb movements during sleep, narcolepsy, REM sleep behavior disorder, insomnia, sleep duration- and circadian rhythm sleep-wake disorders. Post-stroke sleep disturbance has been associated with worse outcome. Conclusion Sleep disorders are risk factors for stroke and associated with worse stroke outcome. They are also a common consequence of stroke. Recent guidelines suggest screening for sleep disorders after stroke. It is possible that treatment of sleep disorders could both reduce stroke risk, and improve stroke outcome, although further data from clinical trials is required.

Association between dietary intake of niacin and stroke in the US residents: evidence from national health and nutrition examination survey (NHANES) 1999–2018

“…Risk factors for stroke include high blood pressure, smoking, diabetes, obesity, and a sedentary lifestyle. Age, family history, and certain medical conditions also contribute to the risk ( 39 , 40 ). Prevention measures often involve lifestyle changes such as maintaining a healthy diet, exercising regularly, managing blood pressure, and avoiding smoking and excessive alcohol consumption ( 41 , 42 ).…”