There's nothing fun about sleep deprivation; forget gracefully meeting deadlines or handling a screaming toddler when you feel dazed after a night of tossing and turning. But the side effects of poor sleep go beyond setting you up for a groggy day. Multiple studies have shown that sleep deprivation and disorders—ranging from insomnia to sleep apnea—impact our well-being. When you don't snooze, you do lose; lack of sleep can impact your weight, immune function and mental clarity.

Indeed, the consequences of not sleeping well or enough might even be more serious than that…we're talking life-or-death serious! A recent study published in Neurology found that sleep duration and sleep disorders, such as obstructive sleep apnea, insomnia, or disturbances like snoring, choking, etc., were significant risk factors for a stroke.

To be clear, researchers did not conclude that these sleeping problems caused a stroke. However, the findings suggest a correlation between inadequate sleep and stroke risk: people with sleep deprivation and sleep disorders are more likely to suffer a stroke than those with quality sleep. On the flip side, people who sleep the "perfect" or recommended seven to nine hours a night were at a reduced risk for stroke, according to these findings.

"We found that sleep disturbance symptoms were common, and associated with a graded increased risk of stroke. These symptoms may be a marker of increased individual risk, or represent independent risk factors," noted the authors of the study.

Can lack of sleep cause a stroke?

There's a strong correlation that has been observed in several studies between poor sleep and the risk for stroke. Lack of sleep (fewer than 7 hours) can cause an increased stroke risk—but so can too much sleep (more than 9 hours.) Indeed, the new study further confirms the importance of getting the right amount of sleep—kind of like Goldilocks, not too much or too little sleep, but just right. And on top of getting enough sleep, sleeping well is also key. That means a restful night free of sleep apnea, insomnia, snoring, etc.

Sleep duration and stroke risk: What’s the connection?

Researchers analyzed data from 4,496 participants, including 1,799 participants with ischemic strokes and 439 participants with hemorrhagic strokes; for each participant who had experienced a stroke, there was a matched control participant who had not. Participants answered questions about their sleep behavior the previous month, including nocturnal sleep duration, sleep quality, and how long it took them to fall asleep (sleep onset latency). They also answered questions about their sleeping patterns, whether they woke during the night, or any daytime napping, and sleep problems, like obstructive sleep apnea, insomnia, snoring, or any other breathing issues during sleep.

The results showed a U-shaped relationship between several outcomes and increased stroke risk.

• Sleeping too little linked to stroke risk:

  People who slept less than five hours a night (short sleep duration) were three times more likely to have a stroke than those who slept seven hours.

• Sleeping too much linked to stroke likelihood:

  People who slept more than nine hours (long sleep duration) were twice as likely to have a stroke than people who slept seven hours.

• Sleep-disordered breathing linked to stroke risk:

  Poor sleep quality and sleep disorders, such as insomnia, apnea, as well as sleep disturbances like snoring, gasping, choking, etc., were also linked with an increased stroke risk.

• Be a cat napper:

  Long, unplanned naps (longer than an hour) were also associated with an increased risk of stroke compared to short (less than an hour) planned naps.

The results highlight the foundational value restful sleep has on the brain and suggest a possible modifiable risk factor for stroke and overall brain health. In other words, assessing sleeping patterns in your next medical check-up can be a proactive way to protect brain health and improve head-to-toe health. "Future clinical trials are warranted to determine the efficacy of sleep interventions in stroke prevention," the study's authors concluded.

What is a stroke?

There are two types of acute stroke, ischemic or hemorrhagic. There are some overlapping risk factors and symptoms, and each requires different treatment.

1. Ischemic stroke

   —This type of stroke refers to a blood vessel blockage, preventing brain tissue from getting nutrient-rich and oxygenated blood.

2. Hemorrhagic stroke

   —This type of strike is due to blood vessels rupturing in the brain (if your blood pressure is high, for example), resulting in intracerebral hemorrhage or blood spilling into the intracranial cavity.

Both types of strokes need interprofessional and multidisciplinary teamwork to recognize and treat patients suffering from acute stroke. And as this new study shows, insomnia and other sleep problems, like sleep apnea (when breathing stops and starts while sleeping) can increase stroke risk, including ischemic stroke.

How should I sleep to avoid a stroke?

Since lack of sleep is associated with stroke risk and other health problems, your best bet is to build sustainable daily habits that promote healthy sleep. Unsure where to start? Here are six tips to help you improve your sleep patterns.

1. Mind light exposure:

   Your body's circadian rhythm is a built-in clock that responds to light cues. You can help balance your sleep-wake clock by exposing yourself to the warm, buttery sunlight as soon as you wake up. And as bedtime approaches, switch to low lighting; this helps your brain and body know it's time to start shutting down.

2. Craft your sleeping space:

   Your bedroom should be your sleep (and sex) sanctuary. Create the ideal sleep environment by making your room dark, cold and quiet (maybe romantic). There's nothing revitalizing about distracting noises and lights or waking up hot and sweaty in the middle of the night—all the while interrupting restful sleep.

3. Establish a sleep routine:

   We are creatures of habit, so going to bed and waking up at the same time also helps balance our circadian rhythm, making it easier to take healthy sleep seriously and make it a priority in our wellness journey.

4. Practice sleep-friendly habits:

   Try to have your last meal of the day at least three hours before bedtime; your body will not get restful sleep if it's busy digesting. Swap screen time (tv, phones, tablets) for a book or light yoga at least two hours before you snooze. Exposing yourself to the blue light from a screen before bed sends "stay active" signals to your brain—not ideal for restful slumber.

5. Work up a sweat:

   Regular exercise is another pillar of wellness. Not only does it promote heart and brain health, but it also helps you get restful shuteye. An early morning workout (or at least three hours before bedtime) gives your body time to wind down. And you don't have to be a gym rat. Carve out 30 minutes at least five days a week to get the health-boosting benefits of full-body movement. Pro tip: Mix it up! Add resistance training and weightlifting two to three days a week to target and tone muscle groups.

6. Add sleep-friendly nutrients:

   Incorporating nutrients like ashwagandha, magnesium and melatonin into your wellness routine can help promote healthy sleeping patterns. Pro tip: You can take a quiz to find tailored sleep support recommendations.

Other health benefits of getting the right amount of sleep

Prioritizing restful, uninterrupted sleep is a proactive way to cultivate a long and healthy life. After all, during sleep our bodies maintain brain and cardiovascular function, immune response and promote balance throughout different biological pathways that keep you healthy and thriving.

If you need another reason to prioritize sleep, here are seven benefits of getting quality sleep.

1. Robust immune response:

   Research shows that sleep deprivation makes us more vulnerable to immune challenges. That's because our bodies upkeep several aspects of health while we rest, including our immune response.

2. Healthy weight management:

   Sleep deprivation has also been linked to weight gain and obesity. That could be because sleep deprivation and sleep problems (like insomnia and sleep apnea) have been linked to hormone imbalance, which can disrupt our eating patterns—studies suggest we're more likely to overeat when we're sleep-deprived. So, prioritizing healthy sleeping patterns can help manage a healthy weight.

3. Lower risk of chronic conditions:

   Getting seven to nine hours of sleep also helps lower risk for other conditions such as cognitive decline, heart disease (including high blood pressure), diabetes and obesity.

4. Less stress and better mood:

   Waking up on the wrong side of bed can leave you cranky and ready to react to even the slightest inconvenience. It's indeed a real struggle to function on short-term sleep. Getting enough sleep encourages a healthy stress response, supporting other aspects of health like blood pressure and helping prevent heart disease.

5. Improved cognition and performance:

   It's no secret that the right amount of quality sleep helps support brain health and performance. Research has shown that a good night's sleep can help improve school and work performance.

6. Better social skills:

   When we prioritize restful sleep, we're in a better mental state and can give time and attention to those around us—we can even socialize out of our comfort zone. When we're running on poor sleep, we're more likely to be short and less patient with others.

7. Make responsible decisions:

   Okay! This one may sound made up, but hear us out. A good night's sleep promotes mental clarity; we can think logically and make intelligent decisions (like not driving when we're sleepy). According to the National Highway Traffic Safety Administration, drowsy driving causes hundreds of fatal accidents every year.

Summary: Sleep and brain health

Let's recap: Sleep is a pillar of brain health and overall wellness. A recent study published in Neurology found sleep duration (too much or too little sleep), sleep disorders like insomnia, sleep deprivation and sleep apnea, were significant risk factors of stroke. This new study confirms previous scientific literature highlighting how imperative sleep quality is to brain (and overall) health. Research suggests the ideal shuteye amount is between seven to nine hours of uninterrupted sleep.

Building sustainable daily practices that support healthy sleep patterns, like screen-fasting after dinner and creating a dark and cool environment for sleep, is a proactive way to encourage restful, quality sleep. And, of course, a sleep-friendly lifestyle will include a balanced diet and regular exercise.

References

• Brunetti, Valerio, et al. "Sleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship." Curr Neurol Neurosci Rep. November 2022. https://pubmed.ncbi.nlm.nih.gov/36190654/
• Hepburn, Madihah, et. al. "Sleep Medicine: Stroke and Sleep." Mo Med. November 2018. https://pubmed.ncbi.nlm.nih.gov/30643347/
• Khot, Sandeep and Lewis B. Morgenstern. "Sleep and Stroke." Stroke. June 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640639/
• McCarthy, Christine Eileen, et al. "Sleep Patterns and the Risk of Acute Stroke: Results from the INTERSTROKE International Case-Control Study." Neurology. April 2023. https://n.neurology.org/content/neurology/early/2023/04/05/WNL.0000000000207249.full.pdf 
• McDermott, Mollie, et. al. "Sleep Disorders and the Risk of Stroke." Expert Rev Neurother. July 2018. https://pubmed.ncbi.nlm.nih.gov/29902391/
• Sanderson, John E., et. al. "Obstructive Sleep Apnoea, Intermittent Hypoxia and Heart Failure With a Preserved Ejection Fraction." Heart. February 2021. https://pubmed.ncbi.nlm.nih.gov/33158933/
• Titova, Olga E., et. al. "Sleep Duration and Stroke: Prospective Cohort Study and Mendelian Randomization Analysis." Stroke. November 2020. https://pubmed.ncbi.nlm.nih.gov/32895015/
• "Drowsy Driving." National Highway Traffic Safety Administration. https://www.nhtsa.gov/risky-driving/drowsy-driving
• "Get Enough Sleep." U.S. Department of Health and Human Services. https://health.gov/myhealthfinder/healthy-living/mental-health-and-relationships/get-enough-sleep
• "Stroke: Causes and Risk Factors." National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/stroke/causes
• "Stroke Signs and Symptoms." Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/signs_symptoms.htm
• "The Science of Sleep: Understanding What Happens When You Sleep." Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-science-of-sleep-understanding-what-happens-when-you-sleep
• "What Are Sleep Deprivation and Deficiency?" National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/sleep-deprivation

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