Association between objective sleep measures and cognitive performance: a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study

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Suemoto, Claudia K. ; Santos, Ronaldo B. ; Giatti, Soraya ; Aielo, Aline N. ; Silva, Wagner A. ; Parise, Barbara K. ; Cunha, Lorenna F. ; Souza, Silvana P. ; Griep, Rosane H. ; Brunoni, Andre R. ; Lotufo, Paulo A. ; Bensenor, Isabela M. ; Drager, Luciano F.

• Document type: Journal article
• Source: Journal of Sleep Research; v. N/A, p. 10-pg., 2022-05-29.

Abstract

Sleep disturbances often co-exist, which challenges our understanding of their potential impact on cognition. We explored the cross-sectional associations of insomnia and objective measures of sleep with cognitive performance in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study stratified by middle-aged and older adults. Participants aged >= 55 years underwent cognitive evaluations, polygraphy for 1 night, and actigraphy for 7 days. Insomnia was evaluated using the Clinical Interview Scheduled Revised. Obstructive sleep apnea (OSA) and short sleep duration (SSD) were defined by an apnea-hypopnea index (AHI) of >= 15 events/h and <6 h/ night, respectively. In 703 participants (mean [SD] age 62 [6] years, 44% men), cognition was evaluated using a 10-word list, verbal fluency, and trail-making tests. The frequencies of insomnia, SSD, and OSA were 11%, 24%, and 33%, respectively. In all, 4% had comorbid OSA and insomnia, and 11% had both OSA and SSD. Higher wake after sleep onset (beta = -0.004, 95% confidence interval [CI] -0.008, -0.001) and the number of awakenings (beta = -0.006, 95% CI -0.012, -0.001) were associated with worse verbal fluency performance. Compared to those without insomnia, older participants with insomnia had worse global performance (beta = -0.354, 95% CI -0.671, -0.038). Insomnia was an effect modifier in the associations between AHI and executive function performance (p for the interaction between insomnia and AHI = 0.004) and between oxygen saturation <90% and memory performance (p for the interaction between insomnia and oxygen saturation = 0.02). Although some associations between sleep measures and cognition were significant, they should be considered with caution due to the large sample size and multiple testing performed in this study. (AU)

• FAPESP's process: 12/02953-2 - Impact of obstructive sleep apnea and sleep duration on the progression of cardiovascular diseases
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 19/23496-8 - Impact of sleep disorders on hypertension: a multifaceted approach
• Grantee: Luciano Ferreira Drager
• Support Opportunities: Research Projects - Thematic Grants