Restless Leg Syndrome, novel sleep index may help predict Stroke recurrence

Researchers in Sweden have found in a new study that sleep-wake disturbances can predict which stroke survivors are at a greater risk of recurrence.A novel sleep burden index incorporating sleep duration, insomnia, apnea, and restless legs syndrome predicted subsequent cardiovascular or cerebrovascular events after acute stroke.

Stroke patients suffering from a greater level of sleep-wake disturbances, which includes events such as insomnia and restless leg syndrome had twofold higher risk of additional cardio-cerebrovascular events in the following 2 years than people with lower scores.

The findings were presented at the 2020 European Academy of Neurology (EAN) Congress, which was held as a virtual meeting due to the COVID-19 pandemic.

The researchers recruited 438 acute stroke patients, 85% with ischemic stroke and 15% with transient ischemic attack (TIA). The age of patients included in the study from 21-86 with a mean age of 65 years. Investigators also noted 64% of this cohort was male. The patients included in the study had data related to stroke characteristics, cardiovascular risk profile, and sleep-disordered breathing recording during the acute phase through interviews, standardized questionnaires, and respirography.

Out of a total of 438 patients included in the study, 85% suffered an ischemic stroke and 15% suffered a transient ischemic attack (TIA). In regard to sleep-wake disturbances, 8% of patients were classified as having restless leg syndrome, 26% suffered from severe sleep-disordered breathing, and 15% reported extreme sleep durations.

The researchers found that a higher sleep burden index was associated with a greater risk of subsequent cerebro-cardiovascular events (OR, 2.10; 95% CI, 1.34-3.30; P <.01). Additionally, results suggest stroke survivors who suffered a subsequent event had higher sleep index burden scores than those who did not (Wilcoxon rank-sum test P <.01).

Although interventional trials investigating the benefit of treating sleep-wake-disturbances after stroke are needed, Dr Simone Duss author of the study, said that sleep-wake disorders, should be more systematically assessed and considered in comprehensive treatment approaches in stroke patients.

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European Academy of Neurology:

Duss S, et al "Sleep-wake disturbances after acute stroke predict a higher risk of subsequent cardiocerebro-vascular events" EAN 2020; Abstract 2078.