Abstract Details

Title Polysomnographic Slow Wave Activity Features Are Associated with Longitudinal Global Amyloid PET Accumulation in Patients with Sleep Apnea

Topic Sleep

Presentation(s) S36 - Sleep Neurology Highlights (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Background The relationship between sleep parameters and longitudinal amyloid accumulation in OSA remains unclear.

Objective To assess whether polysomnographic (PSG) sleep features are associated with Amyloid-PET accumulation in patients with obstructive sleep apnea (OSA).

Design/Methods From the Mayo Clinic Study of Aging cohort, we identified 64 participants >=60 years old who had at least two consecutive Amyloid (PiB)-PET scans and a PSG confirming OSA (AHI≥5/hour) within 5 years of the baseline scan but before the second scan. Annualized PiB-PET accumulation (global ΔPiB/year) was estimated by the difference between the second and first log-transformed global PiB-PET estimations (SUVR) divided by the interval between scans (years). Slow-wave activity (SWA) during NREM sleep was characterized by the mean % relative contribution in slow oscillation (SO) (0.5-0.9 Hz) and delta (1-3.9 Hz) frequency bands, and by their slopes in both frequency ranges (SO-slopes and delta-slope). We fit linear regression models to test for associations between global ΔPiB/year, apnea severity markers and SWA features (mean SO% and delta% or mean SO-slope and delta-slope), after adjusting for age at baseline PiB-PET, APOE4, interval between scans, and baseline amyloid positivity.

Results Participants’ mean age=72.8 ± 7.7 years at baseline; 62.5% male; 93.8% cognitively unimpaired. For 1 s.d. increase in SO% and SO-slope, global ΔPiB/year increased by 0.003375 (95% CI 0.000245;0.006505, p=0.035) and 0.006182 (95% CI: 0.001337; 0.011027, p=0.013), which were comparable to 31% and 50% of the effect size associated with baseline amyloid positivity, respectively. Delta-slope was associated with a reduction in global ΔPiB/year by -0.005893 (95% CI: -0.010681; -0.001105, p=0.017). Sleep apnea severity was not associated with global ΔPiB/year.

Conclusions

Although SO has been implicated in the clearance of amyloid, SO and their slopes also represent increased homeostatic sleep pressure. Increased SO% and SO-slopes in sleep apnea may signal chronically poorer/insufficient sleep, potentially contributing to longitudinal amyloid accumulation.

Authors/Disclosures
Diego Z. Carvalho, MD (Mayo Clinic) PRESENTER	The institution of Dr. Carvalho has received research support from NIA/NIH.
Vaclav Kremen (Mayo Clinic)	Vaclav Kremen has nothing to disclose.
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.
Stuart McCarter, MD (Mayo Clinic)	Dr. McCarter has received research support from NIH.
Jan Bukartyk	No disclosure on file
Scott Przybelski	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.
Gregory A. Worrell, MD (Mayo Clinic College of Medicine)	Dr. Worrell has received stock or an ownership interest from NeuroOne Inc.. Dr. Worrell has received stock or an ownership interest from Cadence Neuroscience Inc. The institution of Dr. Worrell has received research support from NIH. The institution of Dr. Worrell has received research support from Medtronic Inc.. The institution of Dr. Worrell has received research support from Neuropace Inc,. The institution of Dr. Worrell has received research support from Epilepsy Foundation of America. Dr. Worrell has received intellectual property interests from a discovery or technology relating to health care. Dr. Worrell has received intellectual property interests from a discovery or technology relating to health care.
Virend Somers	No disclosure on file
Prashanthi Vemuri, PhD (Mayo Clinic)	The institution of Dr. Vemuri has received research support from NIH.