Sleep Fragmentation, Cerebral Arteriolosclerosis, and Brain Infarct Pathology in Community-Dwelling Older People

BACKGROUND AND PURPOSE—Although several forms of sleep disruption are associated with stroke, few studies have examined the relationship between sleep and histopathologic measures of cerebrovascular disease. We tested the hypothesis that greater sleep fragmentation is associated with a higher burden...

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Bibliographic Details
Published in:Stroke (1970) 2016-02, Vol.47 (2), p.516-518
Main Authors: Lim, Andrew S.P, Yu, Lei, Schneider, Julie A, Bennett, David A, Buchman, Aron S
Format: Article
Language:English
Subjects:
Actigraphy
Aged, 80 and over
Arteriolosclerosis - epidemiology
Arteriolosclerosis - pathology
Autopsy
Brain Infarction - epidemiology
Brain Infarction - pathology
Cerebral Amyloid Angiopathy - epidemiology
Cerebral Amyloid Angiopathy - pathology
Cerebral Infarction - epidemiology
Cerebral Infarction - pathology
Female
Humans
Independent Living
Intracranial Arteriosclerosis - epidemiology
Intracranial Arteriosclerosis - pathology
Logistic Models
Male
Odds Ratio
Severity of Illness Index
Sleep Deprivation - epidemiology
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Summary:BACKGROUND AND PURPOSE—Although several forms of sleep disruption are associated with stroke, few studies have examined the relationship between sleep and histopathologic measures of cerebrovascular disease. We tested the hypothesis that greater sleep fragmentation is associated with a higher burden of cerebral vessel and infarct pathology at autopsy. METHODS—We used ordinal logistic regression models to relate sleep fragmentation measured by actigraphy to the severity of arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy, and the number of macroscopic and microscopic infarcts assessed by structured brain autopsy in 315 participants from the Rush Memory and Aging Project. RESULTS—Greater sleep fragmentation was associated with more severe arteriolosclerosis (odds ratio, 1.27; 95% confidence interval, 1.02–1.59; P=0.03 per 1 SD greater sleep fragmentation) and more subcortical macroscopic infarcts (odds ratio, 1.31; 95% confidence interval, 1.01–1.68; P=0.04). These associations were independent of established cardiovascular risk factors and diseases, and several medical comorbidities. CONCLUSIONS—Sleep fragmentation is associated with arteriolosclerosis and subcortical infarcts in older adults.
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.115.011608