The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder.
Nat Sci Sleep
; 15: 491-498, 2023.
Article
em En
| MEDLINE
| ID: mdl-37408565
ABSTRACT
Study Objectives:
Persistent insomnia disorder (pID) is linked to neurocognitive decline and increased risk of Alzheimer's Disease (AD) in later life. However, research in this field often utilizes self-reported sleep quality data - which may be biased by sleep misperception - or uses extensive neurocognitive test batteries - which are often not feasible in clinical settings. This study therefore aims to assess whether a simple screening tool could uncover a specific pattern of cognitive changes in pID patients, and whether these relate to objective aspect(s) of sleep quality.Methods:
Neurocognitive performance (Montreal Cognitive Assessment; MoCA), anxiety/depression severity, and subjective sleep quality (Pittsburgh Sleep Quality Index PSQI; Insomnia Severity Index ISI) data were collected from 22 middle-aged pID patients and 22 good-sleepers. Patients underwent overnight polysomnography.Results:
Compared to good-sleepers, patients had lower overall cognitive performance (average 24.6 versus 26.3 points, Mann-Whitney U = 136.5, p = <0.006), with deficits in clock drawing and verbal abstraction. In patients, poorer overall cognitive performance correlated with reduced subjective sleep quality (PSQI r(42) = -0.47, p = 0.001; and ISI r(42) = -0.43, p = 0.004), reduced objective sleep quality (lower sleep efficiency r(20) = 0.59, p = 0.004 and less REM-sleep r(20) = 0.52, p = 0.013; and increased sleep latency r(20) = -0.57, p = 0.005 and time awake r(20) = -0.59, p = 0.004). Cognitive performance was not related to anxiety/depression scores.Conclusion:
Using a simple neurocognitive screening tool, we found that pID patients showed cognitive deficiencies that related to both subjective/self-reported and objective/polysomnographic measures of sleep quality. Furthermore, these cognitive changes resembled those seen in preclinical non-amnestic AD, and thus could indicate incumbent neurodegenerative processes in pID. Interestingly, increased REM-sleep was correlated with better cognitive performance. However, whether REM-sleep is protective against neurodegeneration requires further investigation.
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Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article