Magazine article Clinical Psychiatry News

Excessive Daytime Sleepiness May Signal Elevated Stroke Risk

Magazine article Clinical Psychiatry News

Excessive Daytime Sleepiness May Signal Elevated Stroke Risk

Article excerpt

NEW ORLEANS -- People who experience routine episodes of dozing during the daytime may have a higher risk of stroke and other vascular events, according to a prospective, community-based cohort study of more than 2,000 people.

The risk of stroke also appeared to increase as the frequency of daytime dozing rose, suggesting a dose-response effect, Bernadette Boden-Albala, Dr.P.H., reported at the International Stroke Conference 2008.

To investigate the relationship between daytime sleepiness (as a measure of underlying sleep disturbance) and stroke, Dr. Boden-Albala and her associates used data from the multiethnic Northern Manhattan Study of 3,298 residents living in that part of the island. The study has been ongoing since 1993 and stopped enrollment in 2002, but the Epworth Sleepiness Scale (ESS) and other questions about sleep and sleep disorders were not collected until nearly 2004, said Dr. Boden-Albala of the departments of neurology and sociomedical sciences at Columbia University, New York.

A total of 2,092 participants answered questions relating to sleep disturbance for the study. These people had an average age of 73 years and a high school graduation rate of 45%. The study comprised 18% whites, 20% blacks, and 60% Hispanics (2% were other ethnicities).

The investigators asked all of the participants the following questions:

* Do you know or have you been told that you snore?

* Do you know or have you been told that you choke or stop breathing when you are sleeping and, if yes, does it occur less than 5 nights a week (mild to moderate) or more than 5 nights a week (severe)?

Some degree of snoring was reported by 63%, whereas only 6% reported choking or stopping breathing during sleep.

Each participant also answered eight questions on a modified version of the ESS, which asked about daytime sleepiness to document sleep disturbance. The scale asks "How often would you say that you doze while: you're sitting and reading; watching television; sitting inactive in a public place; as a passenger in a car, train, or bus; sitting or talking to someone; sitting quietly after lunch; as a driver in a car; or in any other situation where you doze," Dr. …

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