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In the United States, strokes are the fourth leading cause of death and also a top cause of disability. It’s estimated that more than 795,000 people in the U.S. have a stroke each year.
Strokes occur when a clot or blockage forms in the body and the brain can’t get the blood that it needs, said Dr. Fan Caprio, a vascular neurologist at Northwestern Medicine in Illinois. And data shows they can happen more frequently in the morning.
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“It really can occur at any time of the day, so I want to put that out there first. But when epidemiologists have looked at this topic ... they do show that there’s a spike in the percentage of all stroke patients presenting in the morning time,” Caprio said. “So, the different studies vary in terms of exactly which hours you look at, but sometime between 6 a.m. to 12 p.m. is when patients are coming in.”
There are a few theories on why strokes are more common in the morning hours.
Dr. Dileep Raghvendra Yavagal, a professor of clinical neurology and neurosurgery at UMiami Miller School of Medicine and director of interventional neurology at Jackson Memorial Hospital, said “there is some biology that goes along with why strokes may be more common [in the morning].”
According to Dr. Gregory Albers, a professor of neurosurgery and the director of the Stanford Stroke Center in California, the blood is “stickier” in the morning hours, which makes it more likely to clot. “And our intrinsic mechanisms that dissolve clots in the body are less effective in the early morning hours,” Albers explained.
“The other thing that happens is that there’s a rise in blood pressure,” he continued. “When you’re asleep, in the middle of the night, your blood pressure drops, and then as you are waking up, there’s a rise in blood pressure. Those are the main mechanisms that people think account for the early morning increase in stroke.”
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It’s important to know the signs of stroke, which include changes in balance, vision loss and facial drooping.
Since stroke is so common among adults, it’s important to know the signs of it, but it can be “tricky to notice,” according to Caprio.
“A blockage in the brain doesn’t always bother somebody. Instead, we want people to look out for something that goes missing, because when your brain doesn’t get blood flow, it stops functioning,” she said.
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People should look out for signs of lost neurologic function, which could include vision, speech, movement, sensation and balance, Caprio noted, “especially if it’s on one side of the body.”
“That could be a sign that a part of your brain is not getting the blood that it needs,” she added.
There’s a helpful acronym, BE FAST, which helps folks remember the signs of a stroke.
“B is for balance [loss of balance], E is for eyes [changes in vision such as blurred or loss of vision], F is for face, facial droop, A is for arm weakness, S is for speech, and then T is for time,” Caprio said. “So, as soon as you notice any of these issues, activate your emergency medical services, call 911 right away and get attention.”
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Certain symptoms of stroke such as numbness or weakness are sometimes confused with nerve issues, Albers said — but there’s an important difference.
“The other important aspect about stroke symptoms is they come on instantly. So, if your arm has been getting weaker for days ... that’s not a stroke. It’s your arm is fine, and then bam, all of a sudden it gets weak,” Albers explained.
A healthy diet, exercise regimen and more lifestyle changes can help lower your risk of stroke.
According to Yavagal, “in 2026, stroke is highly preventable.” There’s an 80% chance of preventing a stroke if you follow certain lifestyle interventions.
The American Heart Association recommends people follow rules known as Life’s Essential 8 to lower their risk of cardiovascular disease and stroke.
These 8 factors are:
- Eating a nutritious diet that’s high in fruits, veggies, lean proteins, seeds and nuts
- Getting at least 150 minutes of moderate physical activity (such as walking, gardening) or 75 minutes of vigorous physical activity (such as running, swimming) each week
- Not using tobacco products
- Getting 7 to 9 hours of sleep every night
- Maintaining a healthy weight
- Keeping cholesterol levels in a healthy range
- Managing blood sugar
- Keeping blood pressure levels in a healthy range
If you do have a stroke, it’s important to get medical attention as soon as possible. There are treatments available.
Strokes are often very treatable when someone gets medical attention fast enough, Yavagal stressed. When strokes do occur, they are more often than not a type of stroke called “ischemic stroke,” he said, which accounts for more than 80% of all strokes.
“You can actually reverse stroke if you call 911 and go to a comprehensive stroke center,” he noted. “Why is that? Because we can give clot-busting medications up to four-and-a-half hours” after the stroke occurs.
Even after that time frame, another treatment is available: a thrombectomy, in which the blood clot is removed to restore blood flow, he noted.
In the end, the sooner you get to the doctor, the better. “If you get in early ... you have more treatment options,” Albers added.
“Whether you develop symptoms in the morning or if you wake up with symptoms in the morning, we just want those symptoms to get noticed as quickly as possible and to get to those patients as quickly as possible so that we can see if they’re eligible for these treatments,” said Caprio.
