. 2022 Oct 10;45(10):zsac185.

doi: 10.1093/sleep/zsac185.

Self-reported sleepiness associates with greater brain and cortical volume and lower prevalence of ischemic covert brain infarcts in a community sample

Andrée-Ann Baril^{1

2}, Alexa S Beiser^{1

3

4}, Charles DeCarli⁵, Dibya Himali¹, Erlan Sanchez⁶, Marina Cavuoto⁷, Susan Redline^{8

9}, Daniel J Gottlieb^{8

9

10}, Sudha Seshadri^{1

3

11}, Matthew P Pase^{1

7

12}, Jayandra J Himali^{1

3

4

11

13}

Affiliations

¹ The Framingham Heart Study, Framingham, MA, USA.
² Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
³ Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
⁴ Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
⁵ Department of Neurology, University of California, Davis, CA, USA.
⁶ Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
⁷ Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia.
⁸ Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
⁹ Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
¹⁰ VA Boston Healthcare System, Boston, MA, USA.
¹¹ Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA.
¹² Harvard T.H. Chan School of Public Health, MA, USA.
¹³ Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX, USA.

PMID: 35917199
PMCID: PMC9548673
DOI: 10.1093/sleep/zsac185

Self-reported sleepiness associates with greater brain and cortical volume and lower prevalence of ischemic covert brain infarcts in a community sample

Andrée-Ann Baril et al. Sleep. 2022.

. 2022 Oct 10;45(10):zsac185.

doi: 10.1093/sleep/zsac185.

Authors

Affiliations

¹ The Framingham Heart Study, Framingham, MA, USA.
² Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
³ Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
⁴ Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
⁵ Department of Neurology, University of California, Davis, CA, USA.
⁶ Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
⁷ Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia.
⁸ Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
⁹ Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
¹⁰ VA Boston Healthcare System, Boston, MA, USA.
¹¹ Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA.
¹² Harvard T.H. Chan School of Public Health, MA, USA.
¹³ Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX, USA.

PMID: 35917199
PMCID: PMC9548673
DOI: 10.1093/sleep/zsac185

Abstract

Study objectives: We evaluated if self-reported sleepiness was associated with neuroimaging markers of brain aging and ischemic damage in a large community-based sample.

Methods: Participants from the Framingham Heart Study Offspring cohort (n = 468, 62.5 ± 8.7 years old, 49.6%M) free of dementia, stroke, and neurological diseases, completed sleep questionnaires and polysomnography followed by magnetic resonance imaging (MRI), 3 years later on average. We used linear and logistic regression models to evaluate the associations between Epworth Sleepiness Scale (ESS) scores and total brain, cortical and subcortical gray matter, and white matter hyperintensities volumes, and the presence of covert brain infarcts.

Results: Higher sleepiness scores were associated with larger total brain volume, greater cortical gray matter volume, and a lower prevalence of covert brain infarcts, even when adjusting for a large array of potential confounders, including demographics, sleep profiles and disorders, organic health diseases, and proxies for daytime cognitive and physical activities. Interactions indicated that more sleepiness was associated with larger cortical gray matter volume in men only and in APOE ε4 noncarriers, whereas a trend for smaller cortical gray matter volume was observed in carriers. In longitudinal analyses, those with stable excessive daytime sleepiness over time had greater total brain and cortical gray matter volumes, whereas baseline sleepiness scores were not associated with subsequent atrophy or cognitive decline.

Conclusion: Our findings suggest that sleepiness is not necessarily a marker of poor brain health when not explained by diseases or sleep debt and sleep disorders. Rather, sleepiness could be a marker of preserved sleep-regulatory processes and brain health in some cases.

Keywords: alzheimer’s disease; apolipoprotein E; cortex; dementia; gray matter; infarcts; magnetic resonance imaging; sex; sleep propensity; stroke.

PubMed Disclaimer

Cited by

Sleep Traits Causally Affect the Brain Cortical Structure: A Mendelian Randomization Study.
Chen Y, Lyu S, Xiao W, Yi S, Liu P, Liu J. Chen Y, et al. Biomedicines. 2023 Aug 18;11(8):2296. doi: 10.3390/biomedicines11082296. Biomedicines. 2023. PMID: 37626792 Free PMC article.
Association of Sleep Duration and Change Over Time With Imaging Biomarkers of Cerebrovascular, Amyloid, Tau, and Neurodegenerative Pathology.
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. Baril AA, et al. Neurology. 2024 Jan 9;102(1):e207807. doi: 10.1212/WNL.0000000000207807. Epub 2023 Dec 13. Neurology. 2024. PMID: 38165370 Free PMC article.

References

1. Matricciani L, et al. . Past, present, and future: trends in sleep duration and implications for public health. Sleep Health. 2017;3(5):317–323. doi:10.1016/j.sleh.2017.07.006. - DOI - PubMed
1. Hitchcott PK, et al. . The neurophysiological basis of excessive daytime sleepiness: suggestions of an altered state of consciousness. Sleep Breath. 2020;24(1):15–23. doi:10.1007/s11325-019-01865-9. - DOI - PubMed
1. Wang L, et al. . Association between excessive daytime sleepiness and risk of cardiovascular disease and all-cause mortality: a systematic review and meta-analysis of longitudinal cohort studies. J Am Med Dir Assoc. 2020;21(12):1979–1985. doi:10.1016/j.jamda.2020.05.023. - DOI - PubMed
1. Ohayon MM. Determining the level of sleepiness in the American population and its correlates. J Psychiatr Res. 2012;46(4):422–427. doi:10.1016/j.jpsychires.2011.06.008. - DOI - PubMed
1. D’Ambrosio S, et al. . Sleepiness as a local phenomenon. Front Neurosci. 2019;13:1086. doi:10.3389/fnins.2019.01086. - DOI - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Self-reported sleepiness associates with greater brain and cortical volume and lower prevalence of ischemic covert brain infarcts in a community sample

Affiliations

Self-reported sleepiness associates with greater brain and cortical volume and lower prevalence of ischemic covert brain infarcts in a community sample

Authors

Affiliations

Abstract

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous

Abstract

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous