0707 Factors Associated with Sleepiness and Vigilance in a Cognitively Normal Elderly Population
Introduction Assessment of habitual sleep duration and obstructive sleep apnea (OSA) severity and their relationships with subjective sleepiness and vigilance in cognitively normal older subjects is limited. Methods Data are from subjects participating in an ongoing longitudinal study of sleep and A...
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| Published in: | Sleep (New York, N.Y.) Vol. 42; no. Supplement_1; pp. A283 - A284 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Westchester
Oxford University Press
13-04-2019
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| Online Access: | Get full text |
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| Summary: | Introduction Assessment of habitual sleep duration and obstructive sleep apnea (OSA) severity and their relationships with subjective sleepiness and vigilance in cognitively normal older subjects is limited. Methods Data are from subjects participating in an ongoing longitudinal study of sleep and Alzheimer’s disease biomarkers in cognitively normal elderly subjects (CDR=0, MMSE≥24). Demographic data, comorbidities, medications and Apolipoprotein E4 (ApoE4) genotype were collected. Habitual nocturnal sleep duration was measured by 7-day actigraphy. OSA was evaluated from in-laboratory nocturnal polysomnography (NPSG) and/or 2-night home-sleep test (HST). Excessive daytime sleepiness (EDS) was determined from Epworth Sleep Scale (ESS), and vigilance by 20-min psychomotor vigilance test (PVT). OSA was defined by Apnea hypopnea Index 4 (AHI4)≥5 and/or respiratory disturbance index (RDI)≥15. Results Among 267 subjects (age 68.4±8.1 years, BMI 26.3±5 kg/m2, 36.4% male), 185 underwent HST alone, 11 NPSG alone, and 71 both HST and NPSG. 58.7% of subjects had OSA. Of these, 67.3% had AHI4<15/hr and 32.7% had AHI4≥15/hr. Sleep duration was 7±1.1 hours. Median ESS was 5 (IQR 5), with 16.4% subjects having ESS≥10. Median PVT lapses was 3.2 (IQR 2.7). ESS and PVT showed no relationship (ρ=0.093, p-value 0.14). There was a significant inverse correlation between actigraphy sleep duration and ESS (ρ=-0.348, p-value<0.01), but not lapses. AHI4 (ρ=0.188, p-value<0.01) and RDI (ρ=0.166, p-value 0.01) from HST were correlated with ESS but not PVT. Sleep duration explained 12% of variance in ESS even after adjusting for AHI4. In 82 subjects with NPSG, we found no correlation between ESS or PVT and in-lab total sleep time, sleep stages or OSA severity. No differences in sleepiness were seen in ApoE4 carriers compared to others. Conclusion Our data confirm that OSA is highly prevalent in cognitively normal elderly subjects. We found limited subjective sleepiness, even in those with OSA. Typical sleep duration measured in the home was the main predictor of sleepiness. To date, conventional NPSG metrics do not explain the lack of EDS in OSA in this group. Support (If Any) NIH R01 HL 118624, R01AG056031, K24HL109156 |
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| ISSN: | 0161-8105 1550-9109 |
| DOI: | 10.1093/sleep/zsz067.705 |