Older adults are among those most likely to be troubled by sleep disorders following a stroke, putting them at increased risk for subsequent strokes, according to a new research analysis.

Sleep-related problems generally are more common among stroke survivors than in the general public, investigators say, and include insomnia, troubled breathing while asleep, restless legs in the evening and unconscious leg movements. For the current review, researchers analyzed 185 studies of sleep and stroke survivors, including more than 64,000 participants with specific sleep disorders. They found that approximately 41% of people who had strokes or mini-strokes had insomnia immediately after the stroke, and nearly that many still had trouble sleeping more than three months later. These problems also were reported more often in women and smokers.

Poor sleep is associated with numerous health conditions, and clinicians should be alert to sleep complaints in recent stroke patients, said lead author Hsiao-Yean Chiu, Ph.D., of the School of Nursing at Taipei Medical University, Taiwan.

“When poor sleep occurs, patients may also experience cognitive deficits such as declined concentration or working memory,” Chiu said. In some patients, a sleep study may be warranted, and any sleep issues that arise should be treated, she concluded.

Insomnia usually is assumed to be a mental health issue or is not even addressed by clinicians, said Michael Grandner, Ph.D., a sleep expert at the University of Arizona who was not involved in the study. 

“We think of it as a complaint or something we should just get over,” he said. “These data highlight the fact that it exists in stroke patients, and you shouldn’t ignore it.”

The study was published Thursday in the American Heart Association journal Stroke.