Jay Shafran went to bed with a merger on his mind.
"Our business was struggling, so we were merging with another company," said the 54-year-old New Yorker, who designs and operates fitness centers. "It terms of stress, it was probably a high point."
Despite the stress, Shafran fell asleep only to wake at 3 a.m. feeling awful.
"I tried to get out of bed, but the room was spinning," he said, recalling the wave of nausea and dizziness that had him crawling to the bathroom.
After his worried wife called 911, Shafran was rushed to Downtown Hospital in Manhattan's financial district. A slew of scans revealed the cause of his sudden downturn: a massive stroke in the back of his brain.
"They don't know what caused it," said Shafran, a fit father who had none the traditional risk factors, such as high blood pressure and diabetes. "I don't know if stress caused or contributed to the stroke, but I can tell you I was stressed."
A stroke occurs when a blood vessel in the brain becomes blocked or ruptures, thwarting the flow of oxygenated blood. And while the mechanism is unclear, a new study suggests chronic stress might raise the risk of stroke.
The Spanish study of 450 people found strokes were more common among those with stressful lives and high-strung personalities, even after controlling for risk factors like smoking and diabetes.
"If you have stress, your risk for stroke is heightened," said Dr. Ana Maria Garcia of the Hospital Clinico Universitario San Carlos in Madrid, co-author of the study published today in the Journal of Neurology Neurosurgery and Psychiatry.
The study was unable to conclude that stress causes strokes. It could be, rather, that strokes make people more prone to remembering stressful events. Nevertheless, it adds to mounting evidence that psychological stress can take a physical toll.
Previous studies have linked stress to the common cold, cancer and heart disease. And people with optimistic outlooks, who expect the best in uncertain times, are less likely to suffer strokes, according to a 2011 study published in the journal Stroke.
Garcia said she plans to tease out whether stress management training can reduce the risk of stroke.
Shafran was unconscious for four days after the stroke in his cerebellum, the brain area behind balance.
"When I'm crossing the street, I look both ways, and then I have to wait for world to stop spinning," he said, adding that vestibular therapy helped him recover his equilibrium.
And more than a year later -- after a successful, albeit delayed merger -- he sees the stroke as a wake-up call.
"I'm trying to take more charge of my health -- getting back to exercise, which I had stopped, and being really conscious of what I eat," he said, adding that he takes aspirin and cholesterol medication to stave off strokes and took up meditation to counter stress and help him sleep. "Before the stroke, people would always tell me how tired I looked. Now people say, 'You look great.'"