Cerebrovascular stroke and sleep are closely correlated.1 Several pathophysiological mechanisms have been proposed in the literature that explain the occurrence of a stroke at high rates with certain sleep disorders.2
Obstructive sleep apnea (OSA) is on the top of the list of sleep disorders increasing the risk for cerebrovascular stroke.3 Obstructive sleep apnea increases stroke risk via several direct and indirect mechanisms. Direct mechanisms include increased sympathetic activity, nocturnal hypertension, intermittent hypoxia, arousal responses, hemodynamic instability, oxidative stress, and endothelial dysfunction.4 Indirect mechanisms include increasing the risk for other stroke risk factors such as diabetes mellitus, hypertension, and cardiac arrhythmias. Insomnia, periodic limb movements (PML), and restless leg syndrome (RLS) are other sleep disorders that increase stroke risk. They were proposed to increase the stroke risk via increasing sympathetic activity, micro-arousals, oxidative stress, oxidative stress, hypoxia, inflammation, and metabolic dysregulation. Sleep duration was also reported to be related to stroke. Both long and short sleep duration were reported to increase sleep risk.5
Though the relationship between stroke and sleep is well established, data is scarce about the correlation between sleep architecture and stroke time onset. The sleep architecture was compared between patients with wake-up stroke (WUS) and patients with daytime stroke (DTS) in few studies literature studies, and the data from these studies are conflicting.