Napping Linked with Higher Stroke Risk

By Deborah Jeanne Sergeant

A new study released in a recent issue of the journal Hypertension indicates that daytime sleep sessions may increase risk of hypertension and ischemic stroke.

However, local experts do not lay the blame with napping itself. 

The study included 358,451 UK participants. It found an association, but that does not establish a causal relationship between napping and higher stroke risk. 

Many people with a sleep disorder nap to make up for their sleep deficit. For example, some people need to nap to make up for sleep lost because of sleep apnea, a condition for which obesity is a high-risk factor.

Sleep apnea “very much disrupts and disturbs sleep,” said Laurie Malotte, sleep center coordinator at The Sleep Disorders Center in Canandaigua. “Some people can be aware of it as they snore themselves awake, coughing, gasping and panicking, short of breath. Others aren’t aware of it at all and are told by someone else there’s a problem.”

She also said that obesity is a risk factor for sleep apnea, as is COPD, congestive heart failure and hypertension.

“The sleep apnea can cause or exacerbate these issues,” Malotte said.

These issues also raise risk for stroke. Napping is not directly related to the increased risk for stroke. Someone who exercises and works hard but is overall healthy would have no reason to think naps lead to stroke instead of someone with medical problems that disrupt sleep and concurrently raise risk of stroke.

“The study describes an association between frequency of naps and stroke and not a cause effect,” said Ali El-Solh, associate chief of staff for Research at Veterans Health Administration at Western New York Healthcare System in Buffalo. “First the study was based on self-reporting and not on an objective measure of naps and did not include duration of naps. So, is napping for 30 minutes, one hour, or two hours more likely to result in stroke? The article does not address this question.

“Second, napping could be indicative of another disease that could be linked to stroke. For example, patients with congestive heart failure may nap more because they feel tired. Congestive heart failure is known to be associated with stroke. We assume that napping causes stroke while in reality it is a symptom of another disease linked to stroke. The bottom line is that the study raises more research questions but should not change practice or behavior yet.”

Napping can help people who occasionally need more rest. People who cannot make it through the day without napping should contact a sleep specialist to determine the underlying reason for their lack of rest.

Soda Kuczkowski, sleep health educator and founder of Start with Sleep in Buffalo, said a “power nap” of 10 to 20 minutes can help a person feel recharged after staying up too late or an occasional poor night’s sleep.

“Someone who is not power napping but sleeping 45 minutes to three to four hours: that can leave you groggy,” Kuczkowski said. “When it comes to sleep, it’s about balance.”

She referenced a study that found that people regularly napping had a sleep duration of only six hours, not eight.

“If you’re having to substitute with naps during the day, it’s a sign your sleep is not healthy,” Kuczkowski said. “As we get older, older than 65, we revert back to childhood sleep patterns. Going to bed earlier and getting up earlier. A nap may be needed.”

But for most people, napping “is not a substitute for good, consistent sleep,” she said.

“You need sleep hygiene.”

Sleep hygiene refers to creating the right context for sleep, including a dark, cool, quiet room used. The bed should be used only for rest and intimacy, not watching television or other activities. The bedroom should be comfortably appointed and should not contain items that induce stress, such as a basket of unfolded laundry or stack of bills. People should exercise earlier in the day, not directly before bed as that can raise their body temperature. Engaging in quiet activity before bed and avoiding screens can help promote a restful night’s sleep.

Kuczkowski encourages clients to stick with a consistent sleep schedule, even on weekends.