Andrew S P Lim1, Lei Yu2, Julie A Schneider2, David A Bennett2, Aron S Buchman2. 1. From the Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (A.S.P.L.); Department of Neurological Sciences, Rush Alzheimer's Disease Center (L.Y., J.A.S., D.A.B., A.S.B.) and Department of Pathology (J.A.S.), Rush University, Chicago, IL. andrew.lim@utoronto.ca. 2. From the Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (A.S.P.L.); Department of Neurological Sciences, Rush Alzheimer's Disease Center (L.Y., J.A.S., D.A.B., A.S.B.) and Department of Pathology (J.A.S.), Rush University, Chicago, IL.
Abstract
BACKGROUND AND PURPOSE: Although several forms of sleep disruption are associated with stroke, few studies have examined the relationship between sleep and histopathologic measures of cerebrovascular disease. We tested the hypothesis that greater sleep fragmentation is associated with a higher burden of cerebral vessel and infarct pathology at autopsy. METHODS: We used ordinal logistic regression models to relate sleep fragmentation measured by actigraphy to the severity of arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy, and the number of macroscopic and microscopic infarcts assessed by structured brain autopsy in 315 participants from the Rush Memory and Aging Project. RESULTS: Greater sleep fragmentation was associated with more severe arteriolosclerosis (odds ratio, 1.27; 95% confidence interval, 1.02-1.59; P=0.03 per 1 SD greater sleep fragmentation) and more subcortical macroscopic infarcts (odds ratio, 1.31; 95% confidence interval, 1.01-1.68; P=0.04). These associations were independent of established cardiovascular risk factors and diseases, and several medical comorbidities. CONCLUSIONS: Sleep fragmentation is associated with arteriolosclerosis and subcortical infarcts in older adults.
BACKGROUND AND PURPOSE: Although several forms of sleep disruption are associated with stroke, few studies have examined the relationship between sleep and histopathologic measures of cerebrovascular disease. We tested the hypothesis that greater sleep fragmentation is associated with a higher burden of cerebral vessel and infarct pathology at autopsy. METHODS: We used ordinal logistic regression models to relate sleep fragmentation measured by actigraphy to the severity of arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy, and the number of macroscopic and microscopic infarcts assessed by structured brain autopsy in 315 participants from the Rush Memory and Aging Project. RESULTS: Greater sleep fragmentation was associated with more severe arteriolosclerosis (odds ratio, 1.27; 95% confidence interval, 1.02-1.59; P=0.03 per 1 SD greater sleep fragmentation) and more subcortical macroscopic infarcts (odds ratio, 1.31; 95% confidence interval, 1.01-1.68; P=0.04). These associations were independent of established cardiovascular risk factors and diseases, and several medical comorbidities. CONCLUSIONS: Sleep fragmentation is associated with arteriolosclerosis and subcortical infarcts in older adults.
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