Actigraphy sleep patterns in presymptomatic Alzheimer’s Disease: the potential role of neuroinflammation

Abstract

AbstractBackgroundBoth short and long sleep duration have been associated with increased risk of developing Alzheimer’s Disease (AD). While short sleep has been hypothesized to be a risk factor promoting neurodegenerative processes. Long sleep has been viewed as a marker of ongoing neurodegeneration, potentially as a result of neuroinflammation. The objective of the study is to evaluate sleep patterns measured with actigraphy close to expected symptom onset in association with neuroinflammatory biomarkers. We leveraged the PREVENT‐AD cohort in which participants with a parental history of sporadic AD are studied before clinical onset.Method203 participants (age: 68.5±5.4 years, 151 women) free of dementia were tested with a week of actigraphy. Nighttime sleep duration, time in bed, sleep latency, sleep efficiency, and number of sleep bouts were calculated using the Actiware scoring algorithm (medium threshold). The standard deviation of these characteristics was calculated across actigraphy days to assess day‐to‐day variability. Years to expected onset was calculated by the number of years remaining before the age of clinical onset of a parent, or the earliest age of clinical onset if both parents developed AD. A subset of 100 participants underwent a lumbar puncture, and IL‐6 and MCP‐1 levels were assessed using OLINK technology in cerebrospinal fluid (CSF). The association between sleep characteristics, years to expected onset and inflammatory markers was assessed using linear regressions adjusted for age, sex, and time interval between measurements.ResultBeing closer to expected onset was associated with longer nighttime sleep duration (b = ‐0.19, p = 0.015) and lower sleep bouts day‐to‐day variability (b = 0.17, p = 0.027). Higher CSF IL‐6 was associated with longer sleep duration and time in bed (b = 0.30, p = 0.006; b = 0.24, p = 0.028), whereas higher MCP‐1 was associated with longer nighttime sleep duration (b = 0.25, p = 0.019). Higher CSF MCP‐1 levels were associated with lower sleep bouts day‐to‐day variability and shorter sleep onset latency only in those within 10 years of expected onset (interaction p = 0.012 and 0.061; b = ‐0.31, p = 0.043; b = ‐0.31, p = 0.047).ConclusionProximity to parental onset of sporadic AD onset was associated with a longer sleep profile that is more consolidated and stable, which may be due to proinflammatory processes.