Chronic lack of sleep raises risk of stroke


A new study by the University of Alabama says that people 45 and older who chronically get less than six hours a night of sleep quadruple their risk of suffering a stroke. A lack of sleep does such thing as raise a person's blood pressure, place stress on the heart, and increase inflammation and glucose levels.

To get perspective about the study, which involved 5,600 patients, we turned to Dr. Lawrence Kline, medical director of the Scripps Clinic Viterbi Family Sleep Center in La Jolla.

Dr. Lawrence KlineScripps Health

Q: Have physicians long suspected that a chronic lack of sleep contributed to stroke?

A: Sleep need varies with the individual. Shortening individual natural sleep duration is associated with a number of problems but there is no evidence that using pharmacologic methods to influence the length of sleep is of any benefit. There is much evidence that sleeping pills can be harmful.

Q: Many people who have trouble sleeping have tried for years, without success, to solve the problem. Will a study like this just add to their anxiety, making it even harder for them to get a good night’s sleep?

A: Patients with insomnia do better when they don't worry about their sleep duration. One of the most effective treatments for insomnia is sleep restriction or compression. This is accomplished by reducing the time in bed so the time sleeping while in bed is maximized. Reducing worry about sleep helps most people who are concerned about insomnia.

For most people with insomnia, using cognitive behavior therapy for sleep, maintaining a stable fixed wake-up time, and getting early morning outdoor light without sunglasses for 1 to 2 hours is very effective in helping sleep quality and daytime alertness. It is always best to check with your physician about discontinuing sleeping medications and making certain there are no other sleep disorders contributing to the trouble sleeping.

Q: Do you see evidence that people with chronic sleep problems also are at increased risk of heart attack?

A: Stress can be associated with systemic hypertension and can increase the risk of cardiovascular disease. Patients who worry about sleep are more at risk from the worry than from the duration of self-perceived sleep duration. There are many factors that can influence sleep quality causing sleepiness. This could prompt stimulant use such as caffeine, nicotine or other stimulants which increase risk of systemic hypertension and cardiovascular disease.

It has been well shown in large epidemiologic studies that people who live the longest sleep from 6 and 1/2 to 7 and 1/2 hours. Sleeping too long is just as much a risk to longevity as sleeping too little.

Q: How should people with sleep problems react to this new study?

A: Adequate sleep varies from individual to individual. There is no one trick pony. If your sleep quality is normal your natural sleep onset and natural wake-up time is a good clue to what your individual need is. Trying to modify your biologic requirement with your personal activity schedule is where people can get into difficulty. If you cut off your sleep need you will likely feel sleepy in boring situations.


