Insomnia may be a potential risk factor for a brain bleed from a
ruptured aneurysm along with more well known risk factors of smoking and
high blood pressure, according to new research 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 unruptured blood vessel malformations in the brain called intracranial aneurysms, the majority of which will never rupture. About 2.5% of intracranial aneurysms will rupture, resulting in a subarachnoid hemorrhage,
also called a brain bleed. 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.
“Ruptured aneurysms are
highly fatal. It is, therefore, extremely important to identify
modifiable risk factors that can help prevent aneurysms from rupturing,”
said study author Susanna C Larsson PhD, associate professor in the
unit of cardiovascular and nutritional epidemiology at the Karolinska
Institutet in Stockholm, Sweden, and the unit of medical epidemiology at
Uppsala University in Uppsala, Sweden.
The researchers sought to
determine whether various factors were associated with intracranial
aneurysm and/or the aneurysm rupturing. They studied established risk
factors such as smoking and high blood pressure and also assessed the
link between aneurysms and coffee consumption, sleep, physical activity,
body mass index, blood glucose levels, type 2 diabetes, blood
pressure, cholesterol, chronic inflammation and kidney function.
from several genome-wide association studies were used to gauge genetic
associations to 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 aneurysmal subarachnoid
hemorrhage. Cases of intracranial aneurysm and subarachnoid hemorrhage
were compared to over 59,500 controls to determine genetic
predisposition for aneurysms. According to the analysis:
genetic predisposition for insomnia was associated with a 24% increased
risk for intracranial aneurysm and aneurysmal subarachnoid hemorrhage.
- The risk for intracranial aneurysm was about three times higher for smokers vs. non-smokers.
risk for intracranial aneurysm was almost three times higher for each
10 mm Hg increase in diastolic blood pressure (the bottom number in a
blood pressure reading).
- High triglyceride levels and high BMI
did not demonstrate an increased risk for intracranial aneurysm and
aneurysmal subarachnoid hemorrhage.
“The association between
insomnia and intracranial aneurysm has not been reported previously,
and these findings warrant confirmation in future studies,” Larsson
said. “Our research supports the thinking that risk factors that people
can change or manage may impact brain aneurysms and hemorrhage risk.
Once confirmed, future studies should examine 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,
insufficient and poor-quality sleep and sleep disorders are linked to a
higher risk of high blood pressure. The statement summary notes that
treating people with sleep disorders may provide clinical benefits,
particularly for blood pressure.
Study limitations included that
there was not enough information to adequately analyze some of the risk
factors. In addition, the analysis included only people of European
ancestry; therefore, the findings may not be generalizable to people
from diverse racial and ethnic groups.
Co-authors are Ville Karhunen PhD, Mark K Bakker MSc, Ynte M Ruigrok PhD, and Dipender Gill PhD.
The study was funded by the Swedish Research Council for Health, Working Life and Welfare funded the study.
Source: News Release
American Heart Association
November 3, 2021