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These studies suggest that sleep disturbances, including excessive daytime sleepiness, sleep-disordered breathing, insomnia, and sleep-wake disorders, are common in stroke survivors and can impact stroke risk and outcomes.
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Strokes occurring during sleep are a significant concern, as they can go unnoticed for hours, delaying critical treatment. Understanding the symptoms and risk factors associated with strokes that occur during sleep is crucial for early detection and prevention.
One of the primary indicators of a stroke during sleep is waking up with symptoms that were not present before going to bed. These symptoms can include sudden numbness or weakness, particularly on one side of the body, confusion, trouble speaking or understanding speech, and severe headache with no known cause.
Sleep-disordered breathing (SDB), particularly obstructive sleep apnea (OSA), is prevalent among stroke patients and can be both a risk factor and a consequence of stroke. SDB is characterized by repeated episodes of partial or complete obstruction of the airway during sleep, leading to disrupted sleep and reduced oxygen levels . Symptoms of SDB include loud snoring, choking or gasping during sleep, and excessive daytime sleepiness .
Insomnia and other sleep-wake disturbances (SWD) are also common in stroke patients. These disturbances can manifest as difficulty falling asleep, frequent awakenings during the night, and excessive daytime sleepiness. Insomnia is reported in a significant proportion of stroke survivors, with prevalence rates ranging from 35.9% to 42.6% in different phases post-stroke .
Several sleep disorders are identified as risk factors for stroke. These include:
Pre-morbid sleep disturbances, such as difficulty falling asleep, poor sleep quality, and frequent awakenings, are associated with an increased risk of severe stroke and poorer functional outcomes. A higher number of sleep disturbance symptoms correlates with a greater likelihood of severe stroke and functional deterioration.
The type of stroke can influence whether it occurs during sleep. Lacunar infarctions, a type of ischemic stroke, are more likely to occur during sleep compared to other stroke subtypes like intracerebral hemorrhage and cardioembolic stroke.
Strokes during sleep present unique challenges due to delayed recognition and treatment. Symptoms such as sudden awakening with neurological deficits, sleep-disordered breathing, and insomnia are critical indicators. Understanding the risk factors, including various sleep disorders and pre-morbid sleep disturbances, can aid in early detection and prevention strategies. Further research is needed to explore the efficacy of sleep interventions in reducing stroke risk and improving outcomes for stroke survivors.
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