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Don’t Hit Snooze On Your Brain Health: How Sleep and Strokes Are Related

Poor sleep can put you at risk for stroke, and vice versa. Here’s what you need to know about how to keep your brain healthy and identify a sleep disorder.

Sleep disorders and stroke are two common health problems that affect the lives of millions of Americans. In the U.S., someone has a stroke every 40 seconds—about 800,000 strokes per year. And 40 million Americans suffer from chronic sleep disorders, 95% of which remain unidentified and undiagnosed. While they may seem unrelated, these two conditions are linked because they both center around your brain health.

Sleep Disorders

While there are a number of different sleep disorders, the most common is obstructive sleep apnea (OSA), a condition in which the airway collapses, blocking air from entering through the throat to reach the lungs. “If you suffer from excessive daytime sleepiness, snore loudly or have high blood pressure, these are all signs that you may have a sleep disorder,” says neurologist Dr. John Khoury.

People most at risk for OSA are those who have a body mass index (BMI) above 30, diabetes or a history of heart failure, stroke or transient ischemic attack (TIA). Assessments like the Epworth Sleepiness Scale or STOP-Bang can help you assess your risk for OSA. It’s important to share the results of these questionnaires with your primary care provider so they can talk to you about further evaluations and treatment options.

If left untreated, OSA can result in a number of secondary diseases and conditions, such as:

  • High blood pressure
  • Diabetes
  • Carotid artery disease
  • Atrial fibrillation
  • Heart disease and congestive heart failure
  • Weight gain
  • Reduced blood flow to the brain

Because it affects blood flow to the brain, OSA is also closely linked to the occurrence of stroke.


An ischemic stroke occurs when there is a blockage that prevents blood from flowing to the brain. Stroke symptoms can include numbness or weakness on one side of the body, confusion, trouble speaking or seeing in one or both eyes, difficulty walking, dizziness, loss of balance and severe headache with no known cause.

When it comes to spotting a stroke, remember the acronym F.A.S.T.:

  • Face drooping
  • Arm weakness
  • Speech difficulties
  • Time to call 9-1-1

“It’s important to never try and sleep off symptoms of a stroke. If you spot signs of stroke, go to the emergency room immediately—with a stroke, every minute you wait you are losing potential brain function,” says Dr. Khoury.

While having a sleep disorder may make you more at risk for stroke, having a stroke also puts you at risk for developing a sleep disorder. “If you’ve had a stroke or TIA, you’re 70% percent more likely to have OSA,” says Dr. Khoury. “Stroke causes permanent damage to the brain that can affect your sleep.”

Stroke can damage the areas of your brain that control sleepiness, leading to insomnia, worsened sleep apnea symptoms, restless leg syndrome and dream enactment. This is why stroke and OSA are cyclical if not addressed properly.

Treatment Options

Whether you have sleep apnea, a history of stroke or both, a sleep study can help you get the proper treatment. “For people with severe OSA, getting a sleep study and starting to use a CPAP machine is more effective at preventing a stroke than oral medication,” says Dr. Khoury. “And having a stroke can limit your ability to use a CPAP machine, which makes it even more important to get a sleep study while you’re still healthy—before your OSA causes a stroke.”

You can also take steps to change your lifestyle habits around sleeping. To improve your sleep, Dr. Khoury suggests adopting one or more of these healthy habits:

  • Set a routine wakeup time
  • Expose yourself to bright light during the morning hours
  • Avoid caffeine after 1 p.m.
  • Avoid alcohol
  • Exercise daily
  • Avoid using electronics in your bed, including your phone, laptop, tablet and television

If you’re concerned about your sleep or your risk for stroke, talk to your doctor about getting a sleep study or improving your brain health with lifestyle changes.

[Main photo credit: Trade]

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From the Experts, Healthy You