Sleep disorders and the risk of stroke

Expert Rev Neurother. 2018 Jul;18(7):523-531. doi: 10.1080/14737175.2018.1489239. Epub 2018 Jun 25.


Stroke is a major cause of disability and death in the United States and across the world, and the incidence and prevalence of stroke are expected to rise significantly due to an aging population. Obstructive sleep apnea, an established independent risk factor for stroke, is a highly prevalent disease that is estimated to double the risk of stroke. It remains uncertain whether non-apnea sleep disorders increase the risk of stroke. Areas covered: This paper reviews the literature describing the association between incident stroke and sleep apnea, rapid eye movement sleep behavior disorder, restless legs syndrome, periodic limb movements of sleep, insomnia, and shift work. Expert commentary: Trials of continuous positive airway pressure for stroke prevention in sleep apnea patients have been largely disappointing, but additional trials that target populations not yet optimally studied are needed. Self-reported short and long sleep duration may be associated with incident stroke. However, abnormal sleep duration may be a marker of chronic disease, which may itself be associated with incident stroke. The relationship between non-apnea sleep disorders and incident stroke deserves further attention. Identification of specific non-apnea sleep disorders or sleep problems that convey an increased risk for stroke may provide novel targets for stroke prevention.

Keywords: REM sleep behavior disorder; Sleep-disordered breathing; restless legs syndrome; sleep apnea; sleep duration; stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Extremities / physiology
  • Eye Movements
  • Humans
  • Movement
  • Prevalence
  • Restless Legs Syndrome / complications
  • Risk Factors
  • Self Report
  • Shift Work Schedule
  • Sleep / physiology
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / therapy
  • Sleep Wake Disorders / complications*
  • Sleep Wake Disorders / therapy
  • Stroke / complications*
  • Stroke / epidemiology
  • Stroke / prevention & control
  • Time Factors