NCH doctors discover woman's sleep position linked to multiple strokes

Glenda Bridges, an 83-year-old Naples woman, suffered three strokes without typical risk factors, and the cause was linked to her sleep position compressing a crucial blood vessel.

Bridges recounted her experience, saying, "I had no balance, and my vision was blurry, and I had a drooped, you know, side of my face was drooped." These symptoms marked the first of three strokes she experienced in a matter of days.

Dr. Viktoria Totoraitis, a vascular neurologist at NCH, noting the unusual nature of Bridges' condition, said, "What was even more uncommon is her strokes were all in the same location of the brain." With each stroke causing damage to Bridges' brain, time was critical. After ruling out other causes, Totoraitis took a detective-like approach to solve the mystery.

"Blood vessels are like highways, meaning they each go to a specific territory. So when a patient has a stroke, I know what blood vessel supplies that territory," Totoraitis said. The fact that all of Bridges' strokes were wake-up strokes caught Totoraitis' attention, prompting her to inquire about Bridges' sleep habits.

Bridges described her sleep position as "kind of on my side, all curled up in like a fetal position." This clue led Totoraitis to order special testing, including vessel imaging in Bridges' sleeping position. It was discovered that Bridges had undergone several neck surgeries, including eight cervical fusions, which resulted in her entire neck being fused.

Totoraitis said, "When she's sleeping and curled up like that, because she does have a lot of cervical spinal arthritis, some narrowing, she was pinching off one of her vessels." The combination of surgeries, arthritis, and Bridges' preferred sleep position was compressing a crucial blood vessel.

"For a normal person, if you sleep like this, it's okay, but if you have a lot of spine changes that could cut off that blood flow or oxygen," Totoraitis said. The solution did not require another operation but rather a change in Bridges' sleep position.

Totoraitis suggested, "Let's try sleeping with a soft collar," which proved to be the key to resolving the issue.

Bridges confirmed the effectiveness of this change, saying, "I’ve had no strokes, and I've learned to sleep on my back." This small adjustment has provided her peace of mind each night.

Stroke remains a leading cause of disability in the United States, often requiring intense therapy to regain lost function.

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