Abstract
BackgroundSleep fragmentation was shown to be positively associated with cognitive impairment in patients with cerebral small vessel disease (CSVD); however, the underlying mechanisms are not well characterized. In this study, we sought to clarify this issue by investigating the relationship between non breathing-related sleep fragmentation and brain imaging markers in patients with CSVD.MethodsEighty-four CSVD patients and 24 age- and sex-matched healthy controls were prospectively recruited. All subjects underwent 3.0 T superconducting magnetic resonance imaging and overnight polysomnography. Polysomnography parameters including sleep onset latency (SOL), total sleep time (TST); sleep efficiency (SE), wake after sleep onset (WASO), percentage of each sleep stage (N1, N2, N3 and rapid eye movement [REM]), arousal index (ArI), periodic limb movement in sleep index (PLSMI), and periodic limb movement related arousal index (PLMAI) were compared between CSVD patients and healthy controls. The relationship between arousal index and CSVD markers was explored in the CSVD group.ResultsOn polysomnography, CSVD patients showed significantly higher ArI, WASO, PLSMI, and PLMAI, and lower sleep efficiency and N− 3 ratio compared to healthy controls (p < 0.05). On ordinal logistic regression, higher ArI showed a positive association with the severity of periventricular white matter hyperintensity (odds ratio [OR] 1.121, 95% confidence interval [CI] 0.138–2.185) and perivascular space (OR 2.108, 95% CI 1.032–4.017) in CSVD patients, after adjusting for potential confounding variables.ConclusionsThese preliminary results indicate that non breathing-related sleep fragmentation is common and related to the pathological markers of CSVD patients. Future prospective research is required to determine the causal relationship between sleep parameters and CSVD pathology.
Highlights
Sleep fragmentation was shown to be positively associated with cognitive impairment in patients with cerebral small vessel disease (CSVD); the underlying mechanisms are not well characterized
37 patients were excluded based on the following patient-selection criteria: presence of Obstructive sleep apnea syndrome (OSAS) (n = 11); presence of other medical conditions that interfere with sleep (n = 2); patients taking sleep pills (n = 12); (4) presence of major depression (n = 4); refusal to participate (n = 8)
Among the 84 CSVD patients, 63 complained about poor sleep quality and 54 patients qualified the DSM-5 criteria for chronic insomnia
Summary
Sleep fragmentation was shown to be positively associated with cognitive impairment in patients with cerebral small vessel disease (CSVD); the underlying mechanisms are not well characterized. We sought to clarify this issue by investigating the relationship between non breathing-related sleep fragmentation and brain imaging markers in patients with CSVD. To the best of our knowledge, there is limited data evaluating the status of non-breathing-related sleep fragmentation in CSVD patients; in addition, its relationship with the pathological changes in brain is not well characterized. We observed a positive association of sleep fragmentation with cognitive impairment in CSVD patients; we did not explore the underlying mechanisms, especially the relationship between sleep fragmentation and brain pathological changes. The characteristics of sleep fragmentation could not be well understood due to the lack of healthy controls [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
