José Haba-Rubio1, Helena Marti-Soler2, Nadia Tobback2, Daniela Andries2, Pedro Marques-Vidal2, Gérard Waeber2, Peter Vollenweider2, Armin von Gunten2, Martin Preisig2, Enrique Castelao2, Mehdi Tafti2, Raphaël Heinzer2, Julius Popp1. 1. From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland. jose.haba-rubio@chuv.ch julius.popp@chuv.ch. 2. From the Center for Investigation and Research in Sleep (J.H.-R., N.T., D.A., M.T., R.H.), Institute of Social and Preventive Medicine (H.M.-S), Department of Medicine, Service of Internal Medicine (P.M.-V., G.W., P.V.), Department of Psychiatry, Service of Old-Age Psychiatry (A.v.G., J.P.), Department of Psychiatry (M.P., E.C.), Center for Integrative Genomics (M.T.), Department of Clinical Neuroscience, and Leenaards Memory Center (J.P.), Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland.
Abstract
OBJECTIVE: To assess the association between sleep structure and cognitive impairment in the general population. METHODS: Data stemmed from 580 participants aged >65 years of the population-based CoLaus/PsyCoLaus study (Lausanne, Switzerland) who underwent complete sleep evaluation (HypnoLaus). Evaluations included demographic characteristics, personal and treatment history, sleep complaints and habits (using validated questionnaires), and a complete polysomnography at home. Cognitive function was evaluated using a comprehensive neuropsychological test battery and a questionnaire on the participant's everyday activities. Participants with cognitive impairment (global Clinical Dementia Rating [CDR] scale score > 0) were compared with participants with no cognitive impairment (global CDR score = 0). RESULTS: The 291 participants with a CDR score > 0 (72.5 ± 4.6 years), compared to the 289 controls with CDR = 0 (72.1 ± 4.6 years), had significantly more light (stage N1) and less deep (stage N3) and REM sleep, as well as lower sleep efficiency, higher intrasleep wake, and higher sleepiness scores (all p < 0.05). Sleep-disordered breathing was more severe in participants with cognitive impairment with an apnea/hypopnea index (AHI) of 18.0 (7.8-35.5)/h (p50 [p25-p75]) (vs 12.9 [7.2-24.5]/h, p < 0.001), and higher oxygen desaturation index (ODI). In the multivariate analysis after adjustments for confounding variables, the AHI and the ODI ≥4% and ≥6% were independently associated with cognitive impairment. CONCLUSIONS: Participants aged >65 years with cognitive impairment have higher sleepiness scores and a more disrupted sleep. This seems to be related to the occurrence of sleep-disordered breathing and the associated intermittent hypoxia.
OBJECTIVE: To assess the association between sleep structure and cognitive impairment in the general population. METHODS: Data stemmed from 580 participants aged >65 years of the population-based CoLaus/PsyCoLaus study (Lausanne, Switzerland) who underwent complete sleep evaluation (HypnoLaus). Evaluations included demographic characteristics, personal and treatment history, sleep complaints and habits (using validated questionnaires), and a complete polysomnography at home. Cognitive function was evaluated using a comprehensive neuropsychological test battery and a questionnaire on the participant's everyday activities. Participants with cognitive impairment (global Clinical Dementia Rating [CDR] scale score > 0) were compared with participants with no cognitive impairment (global CDR score = 0). RESULTS: The 291 participants with a CDR score > 0 (72.5 ± 4.6 years), compared to the 289 controls with CDR = 0 (72.1 ± 4.6 years), had significantly more light (stage N1) and less deep (stage N3) and REM sleep, as well as lower sleep efficiency, higher intrasleep wake, and higher sleepiness scores (all p < 0.05). Sleep-disordered breathing was more severe in participants with cognitive impairment with an apnea/hypopnea index (AHI) of 18.0 (7.8-35.5)/h (p50 [p25-p75]) (vs 12.9 [7.2-24.5]/h, p < 0.001), and higher oxygen desaturation index (ODI). In the multivariate analysis after adjustments for confounding variables, the AHI and the ODI ≥4% and ≥6% were independently associated with cognitive impairment. CONCLUSIONS:Participants aged >65 years with cognitive impairment have higher sleepiness scores and a more disrupted sleep. This seems to be related to the occurrence of sleep-disordered breathing and the associated intermittent hypoxia.
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