Sleep-wake Behaviors Associated with Cognitive Performance in Middle-aged Participants of the Hispanic Community Health Study/Study of Latinos

Overview

Journal Sleep Health

Specialty Psychiatry

Date 2024 May 1

PMID 38693044

Authors

Stephen F Smagula

Gehui Zhang

Robert T Krafty

Alberto Ramos

Daniela Sotres-Alvarez

Juleen Rodakowski

Linda C Gallo

Melissa Lamar

Swathi Gujral

Dorothee Fischer

Wassim Tarraf

Yasmin Mossavar-Rahmani

Susan Redline

Katie L Stone

Hector M Gonzalez

Sanjay R Patel

Affiliations

Soon will be listed here.

Abstract

Objectives: Many sleep-wake behaviors have been associated with cognition. We examined a panel of sleep-wake/activity characteristics to determine which are most robustly related to having low cognitive performance in midlife. Secondarily, we evaluate the predictive utility of sleep-wake measures to screen for low cognitive performance.

Methods: The outcome was low cognitive performance defined as being >1 standard deviation below average age/sex/education internally normalized composite cognitive performance levels assessed in the Hispanic Community Health Study/Study of Latinos. Analyses included 1006 individuals who had sufficient sleep-wake measurements about 2years later (mean age=54.9, standard deviation= 5.1; 68.82% female). We evaluated associations of 31 sleep-wake variables with low cognitive performance using separate logistic regressions.

Results: In individual models, the strongest sleep-wake correlates of low cognitive performance were measures of weaker and unstable 24-hour rhythms; greater 24-hour fragmentation; longer time-in-bed; and lower rhythm amplitude. One standard deviation worse on these sleep-wake factors was associated with ∼20%-30% greater odds of having low cognitive performance. In an internally cross-validated prediction model, the independent correlates of low cognitive performance were: lower Sleep Regularity Index scores; lower pseudo-F statistics (modellability of 24-hour rhythms); lower activity rhythm amplitude; and greater time in bed. Area under the curve was low/moderate (64%) indicating poor predictive utility.

Conclusion: The strongest sleep-wake behavioral correlates of low cognitive performance were measures of longer time-in-bed and irregular/weak rhythms. These sleep-wake assessments were not useful to identify previous low cognitive performance. Given their potential modifiability, experimental trials could test if targeting midlife time-in-bed and/or irregular rhythms influences cognition.

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