Cerebrovascular accident (CVA) does not always prevent. And some of its warning signs can appear in the middle of the night. “Sleep is a critical time, because the brain is particularly vulnerable to disorders of oxygenation and blood circulation. warns Dr Gérald Kierzek, medical director of True Medical. There would therefore be nocturnal signs to spot, to know if the risk particularly concerns us. Vigilance is required if you notice the following events.
Intense snoring and pauses in breathing
Snoring heavily, with breathing pauses noticed by your partner, can reveal obstructive sleep apnea syndrome (OSAS). “This disorder causes repeated drops in oxygen in the blood, promoteshigh blood pressureL’vascular inflammation and theatherosclerosis”
underlines our expert. Result: the risk of ischemic stroke is multiplied by 2 to 4.
What to do in this case? Consult a sleep specialist. A test called polysomnography helps confirm the diagnosis. Treatment is often based on CPAP (continuous positive airway pressure), nighttime ventilation by mask.
Waking up confused or disoriented: think about a TIA
Waking up with temporary confusion, slurred speech, or difficulty remembering may suggest a transient ischemic attack (TIA) that occurred during the night. “These mini-strokes are often precursors to a more serious stroke” calls back the doctor.
What to do in this case? In the presence of sudden confusion, speech or motor skills problems: call 15 immediately. Even if the symptoms disappear quickly.
Headaches when you wake up: watch out for high blood pressure
An unusual morning headache, especially if it recurs, can signal nocturnal hypertension, cerebral hypoxia or, more rarely, an aneurysm. All are risk factors for hemorrhagic stroke.
What to do? Measure your blood pressure when you wake up. If headaches are frequent or accompanied by neurological signs: request a CT scan or brain MRI.
Numbness on one side of the body upon waking
Numbness or weakness in an arm or leg (hemibody) upon waking may indicate a stroke that occurred during sleep. It could also be a case of benign nerve compression, but if in doubt, it is better to consult.
What to do? “Use the FAST mark” advises the emergency doctor. A simple way to spot that something is wrong.
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Face: asymmetrical face
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Arm: weak or numb arm
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Speech: difficulty speaking
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Time: emergency, call 15
Nocturnal palpitations: suspect atrial fibrillation
Finally, atrial fibrillation, a heart rhythm disorder common at night, can cause the formation of clots which migrate to the brain and cause a stroke. “A feeling of irregular heart, startled awakenings should alert” insists Dr. Kierzek.
What to do in this case? Do a Holter ECG (24-hour cardiac recording). In the event of confirmed fibrillation, anticoagulant treatment may be prescribed to prevent cerebral embolisms.
Preventing stroke during sleep: good reflexes
Nighttime is not always synonymous with rest for the brain. Certain sleep disorders can contribute to the onset of a stroke. Fortunately, there are a few simple steps you can take to reduce the risks:
- Get screened for sleep apnea if you snore chronically, especially in the event of breathing pauses or unexplained fatigue during the day;
- Monitor your blood pressure closely, including at night: uncontrolled nocturnal hypertension is a major factor in stroke;
- Consult in case of nocturnal palpitations: they can reveal atrial fibrillation, a heart rhythm disorder causing clots;
- Avoid alcohol in the evening, which promotes episodes of apnea and disrupts deep sleep;
- Favor a side sleeping position, recommended to limit airway obstructions.
And above all: in the event of signs suggestive of a stroke – numbness of a limb, sudden speech problems, blurred vision or confusion upon waking – immediately dial 15, even if the symptoms fade. Every minute counts.