Sleep characteristics and risk of Alzheimer’s disease: a systematic review and meta-analysis of longitudinal studies

• Published in: Journal of neurology 2024-07, Vol.271 (7), p.3782-3793
• Main Authors: Wang, Shichan, Zheng, Xiaoting, Huang, Jingxuan, Liu, Jiyong, Li, Chunyu, Shang, Huifang
• Format: Article
• Language: English
• Subjects: Alzheimer Disease - epidemiology; Alzheimer's disease; Daytime; Humans; Longitudinal Studies; Medicine; Medicine & Public Health; Meta-analysis; Movement disorders; Neurodegenerative diseases; Neurology; Neuroradiology; Neurosciences; Review; Risk Factors; Sleep; Sleep - physiology; Sleep and wakefulness; Sleep disorders; Sleep Wake Disorders - epidemiology; Systematic review
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-024-12380-7

Background Alzheimer’s disease (AD) is on the rise in our aging society, making it crucial to identify additional risk factors to mitigate its increasing incidence. This systematic review and meta-analysis aimed to provide updated evidence regarding the association between sleep and AD. Methods We conducted a comprehensive search of MEDLINE, EMBASE, and Web of Science databases from inception to July 2023 to identify longitudinal studies. Adjusted relative risks were pooled for each sleep characteristic, and a dose–response analysis was performed specifically for sleep duration. Results A total of 15,278 records were initially retrieved, and after screening, 35 records were ultimately included in the final analysis. The results showed that insomnia (RR, 1.43; 95%CI, 1.17–1.74), sleep-disordered breathing (RR, 1.22; 95%CI, 1.07–1.39), as well as other sleep problems, including sleep fragmentation and sleep-related movement disorders, were associated with a higher risk of developing AD, while daytime napping or excessive daytime sleepiness (RR, 1.18; 95%CI, 1.00–1.40) only exhibited a trend toward a higher risk of AD development. Furthermore, our analysis revealed a significant association between self-reported sleep problems (RR, 1.34; 95%CI, 1.26–1.42) and the incidence of AD, whereas this association was not observed with sleep problems detected by objective measurements (RR, 1.14; 95%CI, 0.99–1.31). Moreover, both quite short sleep duration ( 8 h) were identified as potential risk factors for AD. Conclusions Our study found the association between various types of sleep problems and an increased risk of AD development. However, these findings should be further validated through additional objective device-based assessments. Additional investigation is required to establish a definitive causal connection between sleep problems and AD.