Insomnia symptoms are associated with an increased risk of stroke, myocardial infarction, and other cardio-cerebral vascular disease (CCVD), a large, prospective study shows.

However, at least one expert urges caution in interpreting the findings, noting that the overall effect is “very small.”

Researchers found early morning awakening (EMA), difficulty initiating or maintaining sleep (DIMS), and daytime dysfunction (DDF) were linked to a 7%, 9%, and 13% elevated CCVD risk, respectively.

In addition, there was a dose-dependent relationship between the number of symptoms and greater CCVD risk. Compared with those who have no insomnia symptoms, the researchers found that one insomnia symptom was tied to a 7% increased incidence of CCVD, two symptoms to a 10% increased incidence, and three symptoms to an 18% increased incidence.

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