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. 2023 Jan;19(1):158-168.
doi: 10.1002/alz.12636. Epub 2022 Mar 17.

Daytime napping and Alzheimer's dementia: A potential bidirectional relationship

Peng Li  1   2 , Lei Gao  1   2   3 , Lei Yu  4 , Xi Zheng  1 , Ma Cherrysse Ulsa  1 , Hui-Wen Yang  1 , Arlen Gaba  1 , Kristine Yaffe  5 , David A Bennett  4 , Aron S Buchman  4 , Kun Hu  1   2 , Yue Leng  5
Affiliations

Daytime napping and Alzheimer's dementia: A potential bidirectional relationship

Peng Li et al. Alzheimers Dement. 2023 Jan.

Abstract

Introduction: Daytime napping is frequently seen in older adults. The longitudinal relationship between daytime napping and cognitive aging is unknown.

Methods: Using data from 1401 participants of the Rush Memory and Aging Project, we examined the longitudinal change of daytime napping inferred objectively by actigraphy, and the association with incident Alzheimer's dementia during up to 14-year follow-up.

Results: Older adults tended to nap longer and more frequently with aging, while the progression of Alzheimer's dementia accelerates this change by more than doubling the annual increases in nap duration/frequency. Longer and more frequent daytime naps were associated with higher risk of Alzheimer's dementia. Interestingly, more excessive (longer or more frequent) daytime napping was correlated with worse cognition a year later, and conversely, worse cognition was correlated with more excessive naps a year later.

Discussion: Excessive daytime napping and Alzheimer's dementia may possess a bidirectional relationship or share common pathophysiological mechanisms.

Keywords: actigraphy; aging; cognitive aging; cohort study; longitudinal association; sleep.

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Figures

Fig. 1.
Fig. 1.. Flow of participants through the study.
Fig. 2.
Fig. 2.. Relationship between daytime napping and Alzheimer’s dementia.
(A-B) Plots show predicted mean levels of nap duration (A) and nap frequency (B) based on mixed models for hypothetical female and male individuals with a mean age of 81 years (mean age of the cohort) who developed mild cognitive impairment (MCI) at 3.7 years after baseline and Alzheimer’s dementia (AD) at 7.6 years after baseline. Predicted 95% confidence intervals are shown as shaded regions. The insets demonstrated the predicted mean levels of nap duration (A) and nap frequency (B) based on mixed models using a subset who never developed MCI during follow up. For better visualization, they are shifted downwards 30 and 1 units, respectively for (A) and (B). (C-D) Plots show cumulative hazard functions for nap duration (C) or nap frequency (D) for two representative individuals. Individuals who napped ≥ 1 hour/day (long nappers) had 1.4-fold increased risk compared to those who napped < 1 hour/day (short nappers). Participants who napped once or more than once a day (frequent nappers) had 40% increased risk of developing Alzheimer’s dementia compared with those who napped less than once a day (infrequent nappers).
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