Insomnia Symptoms and Risk for Stroke in Younger Individuals

The association of insomnia symptoms with the incidence of stroke is stronger among younger individuals than in patients older than 49 years, according to study results presented at the American College of Cardiology (ACC) 2023 conference, held from March 4 to 6, 2023, in New Orleans, Louisiana.

Investigators sought to evaluate the association among insomnia symptoms and incidence of stroke and inflammation. Insomnia symptoms (nonrestorative sleep, waking up too early, difficulty maintaining sleep, difficulty initiating sleep) classified on a 0 to 8 scale represented the independent variable. The association between insomnia symptoms and stroke events was assessed with Cox proportional hazards regression models. The mediating effect of inflammation was evaluated using causal mediation analysis within a counterfactual framework. The role of differences by sex, age, race/ethnicity, and social deprivation index and comorbidities was examined.

A cohort study was conducted using data from the Health and Retirement Study from 2002 to 2020. This included 31,126 participants with a median follow-up of 9 years. Insomnia symptoms ranging from 1 to 4 were associated with increased risk for stroke (hazard ratio [HR], 1.16; 95% CI, 1.02-1.33) vs no insomnia symptoms. Insomnia symptoms ranging from 5 to 8 were associated with a greater increased risk for stroke (HR, 1.51; 95% CI, 1.29-1.77) vs no insomnia symptoms.

Our findings indicate the importance of managing insomnia symptoms to prevent stroke occurrence specifically in the younger population.

Participants aged younger than 50 years had a stronger association between insomnia symptoms ranging from 5 to 8 and increased risk for stroke (HR, 3.84; 95% CI, 1.50-9.85) vs no insomnia symptoms and compared with participants 50 years of age and older (HR, 1.38; 95% CI, 1.18-1.62) vs no insomnia symptoms.“ There was a dose-response in the association between insomnia symptoms and stroke events,” the investigators wrote. “Our findings indicate the importance of managing insomnia symptoms to prevent stroke occurrence specifically in the younger population.”

This article originally appeared on The Cardiology Advisor