PT  - JOURNAL ARTICLE
AU  - Haba-Rubio, José
AU  - Marti-Soler, Helena
AU  - Tobback, Nadia
AU  - Andries, Daniela
AU  - Marques-Vidal, Pedro
AU  - Waeber, Gérard
AU  - Vollenweider, Peter
AU  - von Gunten, Armin
AU  - Preisig, Martin
AU  - Castelao, Enrique
AU  - Tafti, Mehdi
AU  - Heinzer, Raphaël
AU  - Popp, Julius
TI  - Sleep characteristics and cognitive impairment in the general population
AID  - 10.1212/WNL.0000000000003557
DP  - 2017 Jan 31
TA  - Neurology
PG  - 463--469
VI  - 88
IP  - 5
4099  - http://n.neurology.org/content/88/5/463.short
4100  - http://n.neurology.org/content/88/5/463.full
SO  - Neurology2017 Jan 31; 88
AB  - 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.AASM=American Academy of Sleep Medicine; AD=Alzheimer dementia; AHI=apnea-hypopnea index; BMI=body mass index; CDR=Clinical Dementia Rating; CI=cognitive impairment; DSM-IV=Diagnostic and Statistical Manual of Mental Disorders, 4th edition; ESS=Epworth Sleepiness Scale; MCI=mild cognitive impairment; MDD=major depressive disorder; MEQ=Horne and Östberg Morningness-Eveningness Questionnaire; ODI=oxygen desaturation index; PLMS=periodic leg movements during sleep; PSG=polysomnography; PSQI=Pittsburgh Sleep Quality Index; SDB=sleep-disordered breathing; TST=total sleep time; WHR=waist-hip ratio