The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder.

Autor:	Künstler ECS; Department of Neurology, Jena University Hospital, Jena, Germany.; Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, Germany., Bublak P; Department of Neurology, Jena University Hospital, Jena, Germany., Finke K; Department of Neurology, Jena University Hospital, Jena, Germany., Koranyi N; Department of Neurology, Jena University Hospital, Jena, Germany., Meinhard M; Department of Neurology, Jena University Hospital, Jena, Germany., Schwab M; Department of Neurology, Jena University Hospital, Jena, Germany.; Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, Germany., Rupprecht S; Department of Neurology, Jena University Hospital, Jena, Germany.; Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, Germany.
Jazyk:	angličtina
Zdroj:	Nature and science of sleep [Nat Sci Sleep] 2023 Jun 30; Vol. 15, pp. 491-498. Date of Electronic Publication: 2023 Jun 30 (Print Publication: 2023).
DOI:	10.2147/NSS.S399644
Abstrakt:	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. Competing Interests: The authors report no conflicts of interest in this work. (© 2023 Künstler et al.)
Databáze:	MEDLINE
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