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. 2023 Aug;32(4):e13820.
doi: 10.1111/jsr.13820. Epub 2023 Jan 23.

Insomnia and risk of dementia in a large population-based study with 11-year follow-up: The HUNT study

Selma Selbaek-Tungevåg  1   2 , Geir Selbaek  3   4   5 , Bjørn Heine Strand  3   4   6 , Christian Myrstad  3   7 , Gill Livingston  8   9 , Stian Lydersen  10 , Sverre Bergh  3   11 , Linda Ernstsen  1
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Insomnia and risk of dementia in a large population-based study with 11-year follow-up: The HUNT study

Selma Selbaek-Tungevåg et al. J Sleep Res. 2023 Aug.

Abstract

Despite evidence suggesting that insomnia is associated with the risk of dementia and cognitive dysfunction, studies have shown mixed results. Dementia has a long prodromal phase, and studies with long follow-up are required to avoid reverse causality. In our 11-year follow-up study, we assessed whether probable insomnia disorder (PID) based on diagnostic criteria, and insomnia symptoms were associated with risk of all-cause dementia, Alzheimer's disease (AD) and cognition, measured with the Montreal Cognitive Assessment scale. We also examined if Apolipoprotein E genotype modified any associations with dementia through interaction. We analysed data from 7492 participants in the Norwegian Trøndelag Health Study. PID was not associated with all-cause dementia (odds ratio = 1.03, 95% confidence interval = 0.74-1.43), AD (odds ratio = 1.07, 95% confidence interval = 0.71-1.60) or Montreal Cognitive Assessment score (regression coefficient = 0.37, 95% confidence interval = -0.06 to 0.80). The insomnia symptom "difficulties maintaining sleep" was associated with a lower risk of all-cause dementia (odds ratio = 0.81, 95% confidence interval = 0.67-0.98), AD (odds ratio = 0.73, 95% confidence interval = 0.57-0.93), and better Montreal Cognitive Assessment score, mean 0.40 units (95% confidence interval = 0.15-0.64). No interaction with Apolipoprotein E genotype was found. PID and insomnia symptoms did not increase the risk of dementia in our study. More research with longer follow-up is needed, and future studies should explore if the associations to dementia risk vary across insomnia subtypes.

Keywords: DSM-5; HUNT study; cohort studies; disturbed sleep; epidemiology; major neurocognitive disorder.

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