Are caregivers the next to suffer stroke?


  • Conflict of interest: Neither of the authors have any conflict of interest to disclose. We confirm that we have read the journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
  • Funding: Our studies are supported by grants from Associação Fundo de Incentivo à Pesquisa (AFIP) and São Paulo Research Foundation (FAPESP) (grant #2013/14420-1 to L. J. K., grant #2012/08587-8 to K. T. N., and grant #2013/14945-7 to D. N. P.). S.T. and M. L. A. received CNPq fellowships.

Dear editor,

The proportion of disability-adjusted life years after stroke has been progressively increased [1]. The motor or cognitive impairments that remained after stroke often lead to a caregiver patient's dependence. In general, the caregivers are family members who assist the patient.

Male gender, elderly, genetic heredity, hypertension, diabetes, and smoking are some of the reported risk factors for stroke [2]. Recently, studies indicated that sleep may play an important role in cerebrovascular diseases risk. It has been suggested that short sleep duration (<five-hours) correlates with higher incidence of stroke and risk factors for cardiovascular diseases, including obesity, hypertension, and dyslipidemia. Additionally, stroke also changes the patients sleep architecture and quality [3]. This condition may influence the caregiver sleep schedule.

In general, decrease in sleep duration, sleep fragmentation, and higher sleep latencies are frequent complaints of caregivers [4]. Part of these sleep disturbances occur due to physical and psychological distress. Caregivers are often affected by psychiatric disorders, such as depression and anxiety, increasing the risk for insomnia and sleep deprivation [5]. Thus, these sleep disorders of caregivers may lead to health quality impairments, especially cerebrovascular diseases.

Considering that most caregivers are a family member, they are more genetically likely to develop primary disease, such as hypertension, diabetes, and obesity. In addition to this genetic propensity, the sleep architecture and quality impairments of caregivers due to their routine alterations lead to a progressive sleep deprivation, increasing the risk for stroke. Thus, we questioned if the caregivers could be the next individuals to suffer a stroke, that is, representing a stroke high-risk population. Although this question is still unanswered, we believe that more attention to caregivers' health and a primary care should be performed concomitant to the treatment of the stroke patients to prevent the occurrence of cerebrovascular diseases in these individuals.


K. T. N., L. J. K., and A. C. B wrote the manuscript and researched the data; D. N. P. wrote and revised the text; G. A. M., F. M. C., S. T., and M. L. A. contributed to the content.