Abstract

AbstractBackgroundGood sleep is essential for health, yet the role of sleep in dementia risk is incompletely understood. The Sleep and Dementia Consortium (SDC) was established to study associations between polysomnography (PSG)‐derived sleep metrics and the risk of dementia and related cognitive and brain MRI endophenotypes. This study presents the associations of sleep architecture and obstructive sleep apnea (OSA) with cognitive function across participating cohorts.MethodThe SDC curates data from five population‐based cohorts with methodologically consistent, overnight, home‐based PSG and neuropsychological assessments over 5 years of follow‐up. Cohorts include the Atherosclerosis Risk in Communities (ARIC) study, Cardiovascular Health Study (CHS), Framingham Heart Study (FHS), Osteoporotic Fractures in Men Study (MrOS), and Study of Osteoporotic Fractures (SOF). Global cognitive composite scores were derived from principal component analysis as the primary outcome. All sleep metrics were harmonized centrally and then distributed to the participating cohorts for cohort‐specific analysis using linear regression; study‐level estimates were pooled in random effects meta‐analyses. Results are adjusted for demographic variables, the time interval between the PSG and neuropsychological assessment (0‐5 years), body mass index, antidepressant use, and sedative medication use.ResultThe mean age of the cohorts ranged from 58 to 89 years (Figure 1) with a pooled sample of 5,946 participants. As shown in Figure 2, across cohorts, higher REM sleep percentage (pooled β±SE = 0.49±0.18 per % increase; p = 0.008) and Sleep Maintenance Efficiency (pooled β±SE = 0.08±0.03 per % increase; p = 0.01) were associated with better global cognition whereas OSA (Apnea‐hypopnea index [AHI] ≥ 5) was associated with worse global cognition (pooled β±SE = ‐0.06±0.02 vs. AHI<5; p = 0.03). Differences in N3 sleep were not associated with cognition.ConclusionBetter sleep consolidation and higher REM sleep percentage were associated with better cognition whereas OSA was associated with worse cognition over 5‐years follow‐up. The role of interventions to improve sleep for maintaining cognitive function and potentially reduce dementia risk requires investigation.

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