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Andrews MJ, Salat DH, Milberg WP, McGlinchey RE, Fortier CB. Poor sleep and decreased cortical thickness in veterans with mild traumatic brain injury and post-traumatic stress disorder. Mil Med Res 2024; 11:51. [PMID: 39098930 PMCID: PMC11299360 DOI: 10.1186/s40779-024-00557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/15/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Poor sleep quality has been associated with changes in brain volume among veterans, particularly those who have experienced mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). This study sought to investigate (1) whether poor sleep quality is associated with decreased cortical thickness in Iraq and Afghanistan war veterans, and (2) whether these associations differ topographically depending on the presence or absence of mTBI and PTSD. METHODS A sample of 440 post-9/11 era U.S. veterans enrolled in the Translational Research Center for Traumatic Brain Injury and Stress Disorders study at VA Boston, MA from 2010 to 2022 was included in the study. We examined the relationship between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and cortical thickness in veterans with mTBI (n = 57), PTSD (n = 110), comorbid mTBI and PTSD (n = 129), and neither PTSD nor mTBI (n = 144). To determine the topographical relationship between subjective sleep quality and cortical thickness in each diagnostic group, we employed a General Linear Model (GLM) at each vertex on the cortical mantle. The extent of topographical overlap between the resulting statistical maps was assessed using Dice coefficients. RESULTS There were no significant associations between PSQI and cortical thickness in the group without PTSD or mTBI (n = 144) or in the PTSD-only group (n = 110). In the mTBI-only group (n = 57), lower sleep quality was significantly associated with reduced thickness bilaterally in frontal, cingulate, and precuneus regions, as well as in the right parietal and temporal regions (β = -0.0137, P < 0.0005). In the comorbid mTBI and PTSD group (n = 129), significant associations were observed bilaterally in frontal, precentral, and precuneus regions, in the left cingulate and the right parietal regions (β = -0.0094, P < 0.0005). Interaction analysis revealed that there was a stronger relationship between poor sleep quality and decreased cortical thickness in individuals with mTBI (n = 186) compared to those without mTBI (n = 254) specifically in the frontal and cingulate regions (β = -0.0077, P < 0.0005). CONCLUSIONS This study demonstrates a significant relationship between poor sleep quality and lower cortical thickness primarily within frontal regions among individuals with both isolated mTBI or comorbid diagnoses of mTBI and PTSD. Thus, if directionality is established in longitudinal and interventional studies, it may be crucial to consider addressing sleep in the treatment of veterans who have sustained mTBI.
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Affiliation(s)
- Murray J Andrews
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - David H Salat
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02130, USA
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, 02130, USA
- Anthinoula A. Martinos Center for Biomedical Imaging, Boston, MA, 02129, USA
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA.
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA.
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Baril AA, Kojis DJ, Himali JJ, Decarli CS, Sanchez E, Johnson KA, El Fakhri G, Thibault E, Yiallourou SR, Himali D, Cavuoto MG, Pase MP, Beiser AS, Seshadri S. Association of Sleep Duration and Change Over Time With Imaging Biomarkers of Cerebrovascular, Amyloid, Tau, and Neurodegenerative Pathology. Neurology 2024; 102:e207807. [PMID: 38165370 PMCID: PMC10834132 DOI: 10.1212/wnl.0000000000207807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Both short and long sleep duration were previously associated with incident dementia, but underlying mechanisms remain unclear. We evaluated how self-reported sleep duration and its change over time associate with (A)myloid, (T)au, (N)eurodegeneration, and (V)ascular neuroimaging markers of Alzheimer disease. METHODS Two Framingham Heart Study overlapping samples were studied: participants who underwent 11C-Pittsburg Compound B amyloid and 18F-flortaucipir tau PET imaging and participants who underwent an MRI. MRI metrics estimated neurodegeneration (total brain volume) and cerebrovascular injuries (white matter hyperintensities [WMHs] volume, covert brain infarcts, free-water [FW] fraction). Self-reported sleep duration was assessed and split into categories both at the time of neuroimaging testing and approximately 13 years before: short ≤6 hours. average 7-8 hours, and long ≥9 hours. Logistic and linear regression models were used to examine sleep duration and neuroimaging metrics. RESULTS The tested cohort was composed of 271 participants (age 53.6 ± 8.0 years; 51% male) in the PET imaging sample and 2,165 participants (age 61.3 ± 11.1 years; 45% male) in the MRI sample. No fully adjusted association was observed between cross-sectional sleep duration and neuroimaging metrics. In fully adjusted models compared with consistently sleeping 7-8 hours, groups transitioning to a longer sleep duration category over time had higher FW fraction (short to average β [SE] 0.0062 [0.0024], p = 0.009; short to long β [SE] 0.0164 [0.0076], p = 0.031; average to long β [SE] 0.0083 [0.0022], p = 0.002), and those specifically going from average to long sleep duration also had higher WMH burden (β [SE] 0.29 [0.11], p = 0.007). The opposite associations (lower WMH and FW) were observed in participants consistently sleeping ≥9 hours as compared with people consistently sleeping 7-8 hours in fully adjusted models (β [SE] -0.43 [0.20], p = 0.028; β [SE] -0.019 [0.004], p = 0.020). Each hour of increasing sleep (continuous, β [SE] 0.12 [0.04], p = 0.003; β [SE] 0.002 [0.001], p = 0.021) and extensive increase in sleep duration (≥2 hours vs 0 ± 1 hour change; β [SE] 0.24 [0.10], p = 0.019; β [SE] 0.0081 [0.0025], p = 0.001) over time was associated with higher WMH burden and FW fraction in fully adjusted models. Sleep duration change was not associated with PET amyloid or tau outcomes. DISCUSSION Longer self-reported sleep duration over time was associated with neuroimaging biomarkers of cerebrovascular pathology as evidenced by higher WMH burden and FW fraction. A longer sleep duration extending over time may be an early change in the neurodegenerative trajectory.
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Affiliation(s)
- Andrée-Ann Baril
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Daniel J Kojis
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Jayandra J Himali
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Charles S Decarli
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Erlan Sanchez
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Keith A Johnson
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Georges El Fakhri
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Emma Thibault
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Stephanie R Yiallourou
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Dibya Himali
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Marina G Cavuoto
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Matthew P Pase
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Alexa S Beiser
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Sudha Seshadri
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
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6
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Fjell AM, Sørensen Ø, Wang Y, Amlien IK, Baaré WFC, Bartrés-Faz D, Boraxbekk CJ, Brandmaier AM, Demuth I, Drevon CA, Ebmeier KP, Ghisletta P, Kievit R, Kühn S, Madsen KS, Nyberg L, Solé-Padullés C, Vidal-Piñeiro D, Wagner G, Watne LO, Walhovd KB. Is Short Sleep Bad for the Brain? Brain Structure and Cognitive Function in Short Sleepers. J Neurosci 2023; 43:5241-5250. [PMID: 37365003 PMCID: PMC10342221 DOI: 10.1523/jneurosci.2330-22.2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023] Open
Abstract
Many sleep less than recommended without experiencing daytime sleepiness. According to prevailing views, short sleep increases risk of lower brain health and cognitive function. Chronic mild sleep deprivation could cause undetected sleep debt, negatively affecting cognitive function and brain health. However, it is possible that some have less sleep need and are more resistant to negative effects of sleep loss. We investigated this using a cross-sectional and longitudinal sample of 47,029 participants of both sexes (20-89 years) from the Lifebrain consortium, Human Connectome project (HCP) and UK Biobank (UKB), with measures of self-reported sleep, including 51,295 MRIs of the brain and cognitive tests. A total of 740 participants who reported to sleep <6 h did not experience daytime sleepiness or sleep problems/disturbances interfering with falling or staying asleep. These short sleepers showed significantly larger regional brain volumes than both short sleepers with daytime sleepiness and sleep problems (n = 1742) and participants sleeping the recommended 7-8 h (n = 3886). However, both groups of short sleepers showed slightly lower general cognitive function (GCA), 0.16 and 0.19 SDs, respectively. Analyses using accelerometer-estimated sleep duration confirmed the findings, and the associations remained after controlling for body mass index, depression symptoms, income, and education. The results suggest that some people can cope with less sleep without obvious negative associations with brain morphometry and that sleepiness and sleep problems may be more related to brain structural differences than duration. However, the slightly lower performance on tests of general cognitive abilities warrants closer examination in natural settings.SIGNIFICANCE STATEMENT Short habitual sleep is prevalent, with unknown consequences for brain health and cognitive performance. Here, we show that daytime sleepiness and sleep problems are more strongly related to regional brain volumes than sleep duration. However, participants sleeping ≤6 h had slightly lower scores on tests of general cognitive function (GCA). This indicates that sleep need is individual and that sleep duration per se is very weakly if at all related brain health, while daytime sleepiness and sleep problems may show somewhat stronger associations. The association between habitual short sleep and lower scores on tests of general cognitive abilities must be further scrutinized in natural settings.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
- Computational Radiology and Artificial Intelligence, Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Øystein Sørensen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - Inge K Amlien
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Copenhagen, Denmark
| | - David Bartrés-Faz
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Copenhagen, Denmark
- Umeå Center for Functional Brain Imaging, Umeå University, 907 36 Umeå, Sweden
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, 907 36 Umeå, Sweden
- Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital Bispebjerg, 2400 Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, 2020 Copenhagen, Denmark
| | - Andreas M Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Ilja Demuth
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Biology of Aging working group, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10178 Berlin, Germany
- BCRT - Berlin Institute of Health Center for Regenerative Therapies, 13353 Berlin, Germany
| | - Christian A Drevon
- Vitas AS, The Science Park, 0349 Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of 0372 Oslo, Norway
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, 1205 Geneva, Switzerland
- UniDistance Suisse, 3900 Brig, Switzerland
- Swiss National Centre of Competence in Research LIVES, University of Geneva, 1205 Geneva, Switzerland
| | - Rogier Kievit
- Cognitive Neuroscience Department, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Copenhagen, Denmark
- Radiography, Department of Technology, University College Copenhagen, 1799 Copenhagen, Denmark
| | - Lars Nyberg
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
- Umeå Center for Functional Brain Imaging, Umeå University, 907 36 Umeå, Sweden
| | - Cristina Solé-Padullés
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Didac Vidal-Piñeiro
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Leiv Otto Watne
- Oslo Delirium Research Group, Oslo University Hospital, 0424 Oslo, Norway
- Department of Geriatric Medicine, Akershus University Hospital, 1478 Lørenskog, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, 1478, Lørenskog, Norway
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
- Computational Radiology and Artificial Intelligence, Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway
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