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    Posted April 4, 2014 by
    Tainan, Taiwan

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    Insomniacs predisposed increased stroke risk

    Stroke risk significant in young adults with insomnia

    Research shows that insomnia is common in stroke survivors. Some people have insomnia before their stroke, and some develop insomnia after a stroke, according to the National Stroke Association.

    Dr. Ya-Wen Hsu, PhD, assistant professor at Chia Nan University of Pharmacy and Science and the Department of Medical Research at Chi-Mei Medical Center in Taiwan and author of study along with colleagues examined insomnia in relation to subsequent stroke during the 4-year follow-up.

    The study included 21,438 insomniacs that were enrolled with International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for insomnia , (mean age, 52±16 years) and were compared with 64,314 randomly selected, age- and sex-matched non-insomnia enrollees with subsequent hospitalization for stroke during the 4-year follow-up. All participants did not have previous diagnosis of stroke, sleep apnea, and insomnia.

    Individuals with insomnia were further categorized into different subgroups based on their insomnia patterns to explore whether the risk of stroke varies by subtype; difficulty initiating or maintaining sleep; chronic or persistent insomnia lasted one to six months; relapse insomnia was a return of insomnia after being diagnosed free of disease for more than six months at any assessment point during the four-year study; and remission was a change from a diagnosis of insomnia to non-insomnia at the subsequent time point.

    The results showed insomniacs had 54% higher risk of developing stroke compared to non-insomniacs. . Persistent insomniacs had a higher three-year cumulative incidence of stroke compared to the other participants in the remission group.

    The incidence of stroke¬ was eight times higher among those diagnosed with insomnia between 18-34 years old. Beyond age 35, the risk continually decreased.

    Among 583 insomniacs and 962 non-insomniacs were admitted for stroke during the follow-up.

    Evidence shows that insomnia may alter cardiovascular health via systematic inflammation, impaired glucose tolerance, increased blood pressure or sympathetic hyperactivity. Some behavioral factors (e.g., physical activity, diet, alcohol use and smoking) and psychological factors like stress might affect the observed relationship.

    In their conclusion the researchers write “Insomnia predisposes individuals to increased risk of stroke and this association is profound among young adults. Our results underscore the clinical importance of identifying and treating insomnia. A novel behavioral intervention targeting insomnia that may prevent stroke should be explored.”

    According to Dr. Hsu, "We feel strongly that individuals with chronic insomnia, particularly younger persons, see their physician to have stroke risk factors assessed and, when indicated, treated appropriately.” "Our findings also highlight the clinical importance of screening for insomnia at younger ages. Treating insomnia is also very important, whether by medication or cognitive therapy."

    "Individuals should not simply accept insomnia as a benign, although difficult, condition that carries no major health risks," Hsu said. "They should seek medical evaluation of other possible risk factors that might contribute to stroke."

    The study is the first to try to quantify the risk in a large population group and the first to assess if the risk of stroke differs by insomnia subtypes, Hsu said.

    This new research is published in the American Heart Association journal Stroke.
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