title: Wake-up stroke: incidence, risk factors and outcome of acute stroke during sleep in a Japanese population. Takashima Stroke Registry 1988-2003.
abstract: Characterization of the time of stroke onset has been plagued by the problem of determining the time of the onset of events that are detected when the patient awakens. Our aim was to evaluate the characteristics, risk factors and acute fatality associated with wake-up stroke. Data was obtained from Takashima Stroke Registry covering approximately 55,000 residents in central Japan. During the period 1988-2003, information about the situation at stroke onset was available for 897 cerebral infarction (CI) and 335 intracerebral hemorrhage (ICH) events. Differences in characteristics and outcome between stroke during sleep and stroke while awake were explored. Among CI and ICH cases, 9.7 and 11.9% suffered from stroke during sleep, respectively. Hypertension and experiencing a severe event were associated with stroke during sleep among CI. Smoking and experiencing a severe event were associated with stroke during sleep and a drinking history reduced the chance of stroke during sleep among ICH. Acute fatality risks did not differ between stroke during sleep and stroke while awake among both CI and ICH cases. About 1 in 10 stroke patients had an onset of stroke during sleep. Hypertensive, smoker and clinically more severely affected patients had a higher prevalence of stroke during sleep. There were no differences between the 2 groups with respect to acute-case fatality.
authors: Department of Health Science, Shiga University of Medical Science, Otsu, Japan. turin@belle.shiga-med.ac.jp
authors: Tanvir Chowdhury
authors: TC
authors: Turin
authors: Yoshikuni
authors: Y
authors: Kita
authors: Nahid
authors: N
authors: Rumana
authors: Yasuyuki
authors: Y
authors: Nakamura
authors: Naoyuki
authors: N
authors: Takashima
authors: Masaharu
authors: M
authors: Ichikawa
authors: Hideki
authors: H
authors: Sugihara
authors: Yutaka
authors: Y
authors: Morita
authors: Kunihiko
authors: K
authors: Hirose
authors: Akira
authors: A
authors: Okayama
authors: Katsuyuki
authors: K
authors: Miura
authors: Hirotsugu
authors: H
authors: Ueshima
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D012042:Registries; D012307:Risk Factors; D012890:Sleep; D020521:Stroke / Q000453:epidemiology*