Insomnia increases the risk of stroke

When individuals stay up late burning the midnight oil, they may be increasing their risk of a very dangerous event – a stroke.

Circulation | Stress and sleep


Dr. Owen Wiseman, ND
@@drowenwiseman


30 July 2018

What is a stroke?

Strokes are sudden blockages of blood to vessels that supply regions of the brain resulting in cell death and loss of function associated with that unsupplied area.

What does a stroke look like?

The typical picture of an individual having a stroke can be summed up by the mneumonic FAST.

  • Face : drooping of the mouth and/or eye usually on one side, and difficulty moving muscles
  • Arm : difficulty or inability to raise arms, numbness or weakness 
  • Speech : slurred speech, inability to understand what is said to them
  • Time : you need to call 911 immediately

Now while these are representative of the typical stroke picture, they aren’t the always stroke picture. The individual suffering from a stroke may suddenly lose their sense of balance, their vision may undergo changes, they may develop a severe headache, and they may have difficulty swallowing. 

What causes a stroke?

Strokes are often the result of three main events amongst others.

  1. Blood clot – those with poor vascular health and diet are at an increased risk of developing plaque buildup in arteries around the body. When a dam is built, the mighty flow of the river is brought to a trickle or a complete stop leaving the environment beyond the dam to undergo radical changes. When a clot suddenly stops the flow of blood in an area of the brain, the region beyond suffers stress and cell death.
  2. Brain tumour – this is far less likely to cause a sudden stroke, and you may notice typical stroke signs and symptoms develop over a number of weeks or months. This is because the tumour gradually puts pressure on the surrounding blood vessels and may grow to a point of cutting off the supply completely, much like putting a kink in a hose. 
  3. Hemorrhage – a ruptured blood vessel diverts the flow away from the target region. Imagine a river suddenly being diverted from its original destination, eventually that area dries up, much like the brain cells no longer receiving adequate blood flow. This is often the result of an aneurysm, a localized weak point on a blood vessel that causes it to bulge outward like a bubble. With trauma or high pressures, this bubble can burst and lead to a hemorrhagic stroke. 

What events occur during sleep and why do we even need it?

Much like the staff of an Aristocrats home, the clean-up crew goes about its work unseen as you doze away. If you continue to stay awake and prevent the staff from ridding the brain of all the junk, the home falls into a state of disarray. Neurodegenerative diseases begin to develop, inflammatory agents aren’t removed, your attention span and memory begin to decrease, you have difficulties mobilizing and burning fats, and your immune system becomes weakened.

Another major function is what caffeine acts to prevent, the buildup of adenosine. This is a natural byproduct of neuronal metabolism that the brain cells produce as they remain active. When adenosine begins to accumulate in the brain, a sleepy response is triggered in order to clear the accrued molecule out. So continuously consuming caffeine as a way to ward off tiredness only lends to a crash down the road and increases our risk of insomnia, and subsequently a stroke.

How does insomnia make this worse?

Without these critical events taking place, these toxic metabolites and pro-inflammatory are left to build up in the body, circulating to areas such as the brain. A prospective study analyzed the relationship between REM sleep behaviour disorders and the risk of stroke. Those who experienced a lack of REM sleep were at a 157% higher risk of experiencing both an ischemic and hemorrhagic stroke. Another study looked at the risk of stroke in those diagnosed with sleep apnea which often causes sleep that is hardly what one might call restful or rejuvenating.

Are there any remedies to help prevent stroke?

Go. To. Bed. The most obvious answer is allowing your brain to perform the healthy functions that it needs to recharge and prepare for the tasks faced upon waking. 

To help you move into a state of sleep, it’s important to develop your sleep hygiene and a bedtime routine. That includes keeping electronics out of the bedroom as the activities performed on our phones not only stimulate the brain, but the blue wavelength also suppresses the production of melatonin, a sleep related agent.

To help get you fall into dream land, turning to herbal remedies may be the answer you’ve sought all along. Herbs such as passion flower (Passiflora incarnata), valerian (Valeriana officinalis) and hops (Humulus lupulus) all contribute to a faster sleep time and increase the amount of time actually spent in sleep. In a clinical study, passion flower was shown to be as effective as oxazepam, a common benzodiazepine, in the treatment of anxiety and insomnia. The active flavonoids in the plant help to boost the levels of GABA, an inhibitory neurotransmitter leading to a sense of relaxation and helping you drift off. Valerian has a similar action, but this flowering plant also inhibits the metabolism of GABA, meaning it stays active longer and lends to a lengthier sleep. Finally, hops have been shown to relax the brain’s activity during sleep and help maintain the circadian rhythm. Products such as Passion Flower and Deep Sleep contain these plants and can help alleviate insomnia, potentially decreasing your risk of stroke.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769007/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941540/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3548567/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727028/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734149/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449441/

https://www.ncbi.nlm.nih.gov/pubmed/11111831

https://www.ncbi.nlm.nih.gov/pubmed/11679026

https://www.ncbi.nlm.nih.gov/pubmed/16282178

https://www.ncbi.nlm.nih.gov/pubmed/22849837

https://www.ncbi.nlm.nih.gov/pubmed/24136970

https://www.ncbi.nlm.nih.gov/pubmed/24156294

https://www.ncbi.nlm.nih.gov/pubmed/24937041

https://www.ncbi.nlm.nih.gov/pubmed/25012962

https://www.ncbi.nlm.nih.gov/pubmed/25817615

https://www.ncbi.nlm.nih.gov/pubmed/26112302

https://www.ncbi.nlm.nih.gov/pubmed/28389588

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