Insomnia can be a risk factor for a highly fatal brain aneurysm rupture

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Sleep Health | Sleep Review

Insomnia, along with the more well-known risk factors of smoking and high blood pressure, may be a potential risk factor for cerebral hemorrhage from a ruptured aneurysm, according to a new study published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

More than 3% of adults worldwide have non-ruptured blood vessel malformations in the brain called intracranial aneurysms, most of which never rupture. About 2.5% of intracranial aneurysms rupture, causing subarachnoid hemorrhage (SAH), also called cerebral hemorrhage. Subarachnoid hemorrhage is a type of stroke that occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and the skull.

“Broken aneurysms are extremely fatal. Therefore, it is extremely important to identify modifiable risk factors that can help prevent the aneurysm, ”says study author Susanna C. Larsson, PhD, Associate Professor in the Department of Cardiovascular and Nutritional Epidemiology at Karolinska Institutet in Stockholm, Sweden . and the Department of Medical Epidemiology at Uppsala University in Uppsala, Sweden, in a communication.

The researchers tried to determine whether various factors were associated with the intracranial aneurysm and / or the rupture of the aneurysm. They examined established risk factors such as smoking and high blood pressure, and also assessed the relationship between aneurysms and coffee consumption, sleep, physical activity, body mass index (BMI), blood sugar levels, type 2 diabetes, blood pressure, cholesterol, chronic inflammation, and kidney function.

Data from several genome-wide association studies were used to measure genetic associations with lifestyle and cardiometabolic risk factors. Genetic information from a meta-analysis conducted by the International Stroke Genetics Consortium was used to identify nearly 6,300 cases of intracranial aneurysm and nearly 4,200 cases of subarachnoid aneurysmal hemorrhage. Cases of intracranial aneurysm and subarachnoid hemorrhage were compared with over 59,500 controls to determine the genetic predisposition to aneurysms. According to analysis:

  • A genetic predisposition to insomnia was associated with a 24% increased risk of intracranial aneurysms and aneurysmal subarachnoid hemorrhage.
  • The risk of an intracranial aneurysm was about three times higher in smokers compared to non-smokers.
  • The risk of an intracranial aneurysm was almost three times higher for every 10 mm Hg increase in diastolic blood pressure (the lowest value on a blood pressure reading).
  • High triglyceride levels and high BMI did not indicate an increased risk of intracranial aneurysms and aneurysmal subarachnoid hemorrhage.

“The association between insomnia and intracranial aneurysm has not been reported, and these results warrant confirmation in future studies,” says Larsson. “Our research supports the belief that risk factors that humans can change or manipulate can affect the brain aneurysm and the risk of bleeding. Once confirmed, future studies should investigate ways to incorporate this knowledge into prevention programs and therapies. “

According to a 2016 American Heart Association scientific statement, Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health, inadequate and poor sleep and sleep disorders are associated with a higher risk of high blood pressure. The summary of the statement suggests that treating people with sleep disorders can offer clinical benefits, particularly for blood pressure.

One of the limitations of the study was that there was insufficient information to adequately analyze some of the risk factors. In addition, the analysis only included people of European descent; Therefore, the results may not be applicable to people of different races and ethnic groups.

Co-authors are Ville Karhunen, PhD; Mark K. Bakker, MSc; Ynte M. Ruigrok, PhD; and dependent Gill, PhD.

The study was funded by the Swedish Research Council for Health, Working Life and Welfare.

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