Poor Sleep, Cardiometabolic Health May Increase Risk for Cognitive Impairment

Julio Fernandez-Mendoza, PhD

Poor sleep or chronic insomnia, with less than 6 hours of sleep per night, is associated with an increased risk for cognitive impairment (CI), and particularly vascular cognitive impairment (VCI), in adults with cardiometabolic risk factors (CMR), according to study results.

The findings were presented at SLEEP 2019, June 8-12 in San Antonio, Texas.

Previous research has demonstrated an association between insomnia and short sleep duration with CMR, including hypertension and diabetes, cerebrovascular or cardiovascular disease (CBVD), and worse cognitive performance.

In order to better understand risk for CI in this population, investigators led by Julio Fernandez-Mendoza, PhD, of Penn State University College of Medicine, used data from the Penn State Adult Cohort (N=1741) to evaluate cognitive impairment in adults with an objective sleep duration indicating normal sleep, poor sleep, or chronic insomnia.

Of the cohort, 52.2% were women, with a median age of 48.8, and 152 participants had cognitive impairment as measured by a neuropsychological battery that assessed processing speed, executive attention, short-term visual memory, verbal fluency, and global cognitive status. Among the cohort, 1022 participants reported normal sleep, 520 reported poor sleep, and 199 reported chronic insomnia. Objective short sleep duration, which was based on a 1-night, 8-hour, in-lab polysomnography evaluation, was defined as <6 hours of sleep.

When compared with the reference group, participants with poor sleep or chronic insomnia who slept <6 hours had a statistically significant increased risk for CI (odds ratio [OR] 2.26; 95% CI, 1.26-4.04 and OR 2.65; 95% CI, 1.28-5.51, respectively), and particularly VCI (OR 2.43; 95% CI, 1.25-4.73 and OR 3.15; 95% CI, 1.42-7.00, respectively).

Notably, those with poor sleep or chronic insomnia who slept >6 hours per night did not show a statistically significant risk for either type of CI (OR 0.46; 95% CI, 0.18- 1.21 and OR 0.66; 95% CI, 0.19-2.37, respectively; VCI: OR 0.78; 95% CI, 0.29-2.10 and OR 0.63; 95% CI, 0.14- 2.93, respectively).

All told, the data demonstrated an increased risk for CI in patients with cardiometabolic risk factors.

“These data further support that this insomnia phenotype is a more severe form of the disorder associated with physiological hyperarousal and cardiometabolic and neurocognitive sequelae,” the investigators concluded.

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REFERENCE

Fernandez-Mendoza J, He F, Vgontzas AN, Calhoun SL, Liao D, Bixler EO. Insomnia with objective short sleep duration is associated with cognitive impairment: a closer look at cardiometabolic brain health. Presented at: SLEEP 2019. June 8-12, 2019; San Antonio, TX. Abstract 0355.