The potential impact of sleep-related movement disorders on stroke risk: A population-based longitudinal study

Abstract

Background: Sleep-related movement disorders (SRMD) have been shown to increase the risk of cardiovascular diseases. However, the relationship between SRMD and stroke remains unclear. Aim: To explore the relationship between SRMD and stroke in the general population. Design: Two cohorts of patients with SRMD and without SRMD were followed up for the occurrence of hemorrhagic and ischemic stroke. Methods: The study cohort enrolled 604 patients who were initially diagnosed as SRMD between 2000 and 2005. 2,416 age- and sex-matched patients without prior stroke were selected as the comparison cohort. A Cox-proportional hazard regression analysis was performed for multivariate adjustment. Results: Patients with SRMD had a higher risk for developing all-cause stroke [adjusted hazard ratio (HR) ¼ 2.29, 95% confidence interval (CI) ¼ 1.42–3.80]. Patients of below 45 years old had the greatest stroke risk (HR ¼ 4.03, 95% CI ¼ 3.11–5.62), followed by patients aged 65 years (HR ¼ 2.64, 95% CI ¼ 1.12–3.44) and 45–64 years (HR ¼ 1.07, 95% CI ¼ 1.02–1.71). The age-stratified analysis suggested that the increased risk of hemorrhagic stroke was more significant than ischemic stroke among all age groups. Furthermore, males with SRMD were at greater risk to develop all-cause stroke (HR ¼ 2.98, 95% CI ¼ 1.74–4.50) than that of females (HR ¼ 1.94, 95% CI ¼ 1.01–3.77). Conclusions: Patients with SRMD were found to have an increased risk of all-cause stroke along with a higher possibility of hemorrhagic stroke over ischemic stroke.