Abstract Details

Title Reduced Slow-Wave Sleep and Severe Sleep Apnea are Associated with Neuroimaging Biomarkers of Cerebrovascular Disease

Topic Sleep

Presentation(s) S6 - Sleep Medicine Highlights (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Background White matter abnormalities are reflective of vascular contributions to cognitive impairment and dementia (VCID) in the elderly, but their relationship with sleep remains unclear.

Objective We aimed to investigate whether polysomnographic (PSG) sleep parameters are associated with neuroimaging biomarkers of cerebrovascular disease in older adults.

Design/Methods From the population-based Mayo Clinic Study of Aging, we identified 140 non-demented participants who underwent at least one brain MRI and a split-night PSG. We quantified two VCID biomarkers - white matter hyperintensities (WMH) from FLAIR-MRI (n=140) and fraction anisotropy of the genu of the corpus callosum (genu FA) from diffusion MRI (n=103). For this cross-sectional analysis, we fit linear models to assess associations between diagnostic PSG parameters (N1%, N3%, mean oxyhemoglobin saturation, and log of AHI) and VCID biomarkers (log of WMH and log of genu FA), respectively, while adjusting for age (at MRI), sex, APOΕ4 status, composite cardiovascular and metabolic conditions (CMC) score, REM%, supine%, sleep duration (from diagnostic portion), and interval between MRI and PSG.

Results The absolute median [IQR] interval between MRI imaging and PSG was 1.74 [0.9 – 3.2] years. For every 10-point decrease in N3%, there was a 0.058 (95% CI 0.006 to 0.111, p=0.030) increase in the log of WMH and 0.006 decrease ([95% CI -0.012 to -0.0002], p=0.042) in the log of genu FA. Participants with severe sleep apnea had higher WMH burden when compared to those with mild disease, after matching for age, sex, and N3% (median [IQR] of 0.0073 [0.0044 - 0.0149] vs 0.0067 [0.0034 to 0.01], p=0.039).

Conclusions

We found that reduced slow-wave sleep and severe sleep apnea were associated with higher burden of white matter abnormalities in predominantly cognitively unimpaired older adults, which contribute to greater risk of cognitive impairment, dementia, and stroke. Our study provides support for the links between sleep depth/fragmentation and intermittent hypoxia and VCID.

Authors/Disclosures
Diego Z. Carvalho, MD (Mayo Clinic) PRESENTER	The institution of Dr. Carvalho has received research support from NIA/NIH.
Stuart McCarter, MD (Mayo Clinic)	Dr. McCarter has received research support from NIH.
Erik K. St. Louis, MD (Mayo Clinic)	Dr. St. Louis has received publishing royalties from a publication relating to health care. Dr. St. Louis has received publishing royalties from a publication relating to health care.
Scott Przybelski	No disclosure on file
	No disclosure on file
Bradley F. Boeve, MD, FAAN (Mayo Clinic)	Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic)	Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nestle. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.
Clifford R. Jack, Jr., MD (Mayo Clinic)	The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.
Jonathan Graff-Radford, MD, FAAN	Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics.
Prashanthi Vemuri, PhD (Mayo Clinic)	The institution of Dr. Vemuri has received research support from NIH.