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Medscape
a day ago
- Health
- Medscape
Sleep, Small Vessel Disease, and Cognition in Minor Stroke
Disturbed sleep was associated with greater small vessel disease (SVD) burden and worse cognitive performance in patients with transient ischaemic attack (TIA) or mild stroke. METHODOLOGY: This cross-sectional study analysed 422 patients with TIA or mild stroke from two prospective cohorts (Edinburgh-UK, n = 211 and Hong Kong, n = 211) between 2018 and 2022, with all participants assessed at 1-3 months post-stroke. Participants underwent brain MRI for assessing markers of SVD (Fazekas white matter hyperintensities [WMHs], lacunes, perivascular spaces, and microbleeds) and the Montreal Cognitive Assessment (MoCA) for evaluating cognition. Self-reported sleep metrics (in-bed time, nighttime sleep duration, sleep latency, and sleep efficiency) were extracted from an adapted Pittsburgh Sleep Quality Index. The main outcome was SVD burden; the secondary outcome was the total MoCA score. TAKEAWAY: Longer in-bed time was independently associated with increased summary SVD burden (odds ratio [OR], 1.27 per 1-SD increase; false discovery rate-adjusted P = .04) and greater periventricular burden (OR, 1.53 per 1-SD increase; P = .003). = .04) and greater periventricular burden (OR, 1.53 per 1-SD increase; = .003). Increased sleep duration was not associated with cognitive performance/longer in-bed time was significantly associated with a lower total MoCA score (standardised β, −0.58; P = .02). = .02). Longer sleep duration was associated with an increased presence of cerebral microbleeds (OR, 1.42 per 1-SD increase; P = .04), although it was not significantly related to other SVD markers. = .04), although it was not significantly related to other SVD markers. In-bed time (r, 0.52) and sleep efficiency (r, 0.56) were positively correlated with sleep duration; sleep latency was negatively correlated with sleep duration (r, −0.24; P < .001 for all). IN PRACTICE: "2 markers of disturbed sleep, longer in-bed time and longer sleep duration, were cross-sectionally associated with greater SVD burden and worse cognitive performance in patients with TIA/mild stroke," the authors wrote. SOURCE: This study was led by Dillys Xiaodi Liu, Division of Neurology, Department of Medicine, The University of Hong Kong, Hong Kong, China, and was published online on May 28, 2025, in Neurology . LIMITATIONS: The cross-sectional design and visual assessments of WMHs and brain atrophy limited precision. Patients with a history of sleep apnoea were not excluded, and changes in sleep quality over time were not assessed. As only baseline cross-sectional data were analysed, causal relationships cannot be established, and findings may differ in longitudinal contexts. DISCLOSURES: This study was supported by the UK Dementia Research Institute, European Union Horizon 2020, Row Fogo Charitable Trust, and other funding agencies. The authors reported having no conflicts of interest.
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South China Morning Post
10-02-2025
- Health
- South China Morning Post
Safeguarding public health – Call for a total ban on flavoured tobacco and possession of alternative smoking products
[The content of this article has been produced by our advertising partner.] Hong Kong Council on Smoking and Health (COSH) and academics from The University of Hong Kong released new tobacco control surveys which show a higher rate of flavoured cigarette use among teenagers and women. Mr Henry TONG Sau-chai, COSH Chairman, said, 'Menthol, fruit, and other tobacco flavours added by the tobacco industry are a significant factor that encourages teenagers and women to first try and then continue smoking. Flavoured tobacco does harm to our next generation by increasing addiction levels among young people, making it harder for them to quit.' 'In the long term, flavoured tobacco poses a major obstacle to decreasing the prevalence of smoking in Hong Kong and undoubtedly raises public health concerns.' Mr TONG said. 'COSH urges the Government to institute a total ban on flavoured tobacco as soon as possible and to implement multiple short, medium, and long-term tobacco control measures to protect the health of Hong Kong residents by curbing this resurgent area of tobacco-related harm.' Higher flavoured cigarette smoking rates in young adults and women The Tobacco Control Policy-related Survey commissioned by COSH and conducted by The University of Hong Kong from January to May 2024 found that nearly half of current smokers use flavoured cigarettes, with higher rates among teenagers and women. Over 86 percent of female smokers aged 15-29 are using flavoured cigarettes, the highest among all age groups. Flavoured cigarettes have increased levels of addiction among young smokers, offering an easy lure for teenagers to fall into nicotine addiction. The survey found that nearly 40 percent (36.2 percent) of teenagers who use flavoured cigarettes are moderately to severely addicted, which is twice the rate of those using non-flavoured cigarettes (16.7 percent). The survey also indicated that young smokers of flavoured cigarettes are more likely to also be using alternative smoking products (including e-cigarettes and heated tobacco products) and waterpipes. Professor Kelvin WANG Man-ping, Professor, The School of Nursing, The University of Hong Kong, said, 'Teenagers and women are increasingly attracted to flavoured tobacco products, with preferences for particular flavours and brands. This phenomenon makes it more likely they will take up smoking, develop an addiction, and continue smoking as a habit. Certain flavourings (such as menthol, cocoa, sweeteners, etc.) used in flavoured cigarettes can promote the absorption of nicotine and enhance nicotine's effects on the brain, thus exacerbating the addiction, leading smokers to smoke more frequently and for longer periods of time, and making it more difficult to quit the habit. According to the survey, over 70 percent of the public support banning flavoured tobacco products, and this percentage continues to rise – a clear indication of societal support for a ban on flavoured tobacco and of the urgent need for legislation.' Flavoured tobacco leads to addiction in teenagers
