The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder
Erika CS Künstler,1,2 Peter Bublak,1 Kathrin Finke,1 Nicolas Koranyi,1 Marie Meinhard,1 Matthias Schwab,1,2 Sven Rupprecht1,2 1Department of Neurology, Jena University Hospital, Jena, Germany; 2Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, GermanyCorres...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-06-01
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| Series: | Nature and Science of Sleep |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-relationship-between-cognitive-impairments-and-sleep-quality-measu-peer-reviewed-fulltext-article-NSS |
| _version_ | 1797789338355892224 |
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| author | Künstler ECS Bublak P Finke K Koranyi N Meinhard M Schwab M Rupprecht S |
| author_facet | Künstler ECS Bublak P Finke K Koranyi N Meinhard M Schwab M Rupprecht S |
| author_sort | Künstler ECS |
| collection | DOAJ |
| description | Erika CS Künstler,1,2 Peter Bublak,1 Kathrin Finke,1 Nicolas Koranyi,1 Marie Meinhard,1 Matthias Schwab,1,2 Sven Rupprecht1,2 1Department of Neurology, Jena University Hospital, Jena, Germany; 2Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, GermanyCorrespondence: Erika CS Künstler, Department of Neurology, Jena University Hospital, Am Klinikum 1, Jena, 07747, Germany, Tel +49 3641 9323525, Email Erika.Kuenstler@med.uni-jena.deStudy Objectives: Persistent insomnia disorder (pID) is linked to neurocognitive decline and increased risk of Alzheimer’s Disease (AD) in later life. However, research in this field often utilizes self-reported sleep quality data - which may be biased by sleep misperception - or uses extensive neurocognitive test batteries - which are often not feasible in clinical settings. This study therefore aims to assess whether a simple screening tool could uncover a specific pattern of cognitive changes in pID patients, and whether these relate to objective aspect(s) of sleep quality.Methods: Neurocognitive performance (Montreal Cognitive Assessment; MoCA), anxiety/depression severity, and subjective sleep quality (Pittsburgh Sleep Quality Index: PSQI; Insomnia Severity Index: ISI) data were collected from 22 middle-aged pID patients and 22 good-sleepers. Patients underwent overnight polysomnography.Results: Compared to good-sleepers, patients had lower overall cognitive performance (average: 24.6 versus 26.3 points, Mann–Whitney U = 136.5, p = < 0.006), with deficits in clock drawing and verbal abstraction. In patients, poorer overall cognitive performance correlated with reduced subjective sleep quality (PSQI: r(42) = − 0.47, p = 0.001; and ISI: r(42) = − 0.43, p = 0.004), reduced objective sleep quality (lower sleep efficiency: r(20) = 0.59, p = 0.004 and less REM-sleep: r(20) = 0.52, p = 0.013; and increased sleep latency: r(20) = − 0.57, p = 0.005 and time awake: r(20) = − 0.59, p = 0.004). Cognitive performance was not related to anxiety/depression scores.Conclusion: Using a simple neurocognitive screening tool, we found that pID patients showed cognitive deficiencies that related to both subjective/self-reported and objective/polysomnographic measures of sleep quality. Furthermore, these cognitive changes resembled those seen in preclinical non-amnestic AD, and thus could indicate incumbent neurodegenerative processes in pID. Interestingly, increased REM-sleep was correlated with better cognitive performance. However, whether REM-sleep is protective against neurodegeneration requires further investigation.Keywords: insomnia, sleep, neurodegeneration, Alzheimer’s disease, polysomnography, cognitive screening |
| first_indexed | 2024-03-13T01:49:13Z |
| format | Article |
| id | doaj.art-27d33446bffe4cb59bbb3f22ad681ad0 |
| institution | Directory Open Access Journal |
| issn | 1179-1608 |
| language | English |
| last_indexed | 2024-03-13T01:49:13Z |
| publishDate | 2023-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Nature and Science of Sleep |
| spelling | doaj.art-27d33446bffe4cb59bbb3f22ad681ad02023-07-02T19:49:20ZengDove Medical PressNature and Science of Sleep1179-16082023-06-01Volume 1549149884824The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia DisorderKünstler ECSBublak PFinke KKoranyi NMeinhard MSchwab MRupprecht SErika CS Künstler,1,2 Peter Bublak,1 Kathrin Finke,1 Nicolas Koranyi,1 Marie Meinhard,1 Matthias Schwab,1,2 Sven Rupprecht1,2 1Department of Neurology, Jena University Hospital, Jena, Germany; 2Interdisciplinary Centre for Sleep and Ventilatory Medicine, Jena University Hospital, Jena, GermanyCorrespondence: Erika CS Künstler, Department of Neurology, Jena University Hospital, Am Klinikum 1, Jena, 07747, Germany, Tel +49 3641 9323525, Email Erika.Kuenstler@med.uni-jena.deStudy Objectives: Persistent insomnia disorder (pID) is linked to neurocognitive decline and increased risk of Alzheimer’s Disease (AD) in later life. However, research in this field often utilizes self-reported sleep quality data - which may be biased by sleep misperception - or uses extensive neurocognitive test batteries - which are often not feasible in clinical settings. This study therefore aims to assess whether a simple screening tool could uncover a specific pattern of cognitive changes in pID patients, and whether these relate to objective aspect(s) of sleep quality.Methods: Neurocognitive performance (Montreal Cognitive Assessment; MoCA), anxiety/depression severity, and subjective sleep quality (Pittsburgh Sleep Quality Index: PSQI; Insomnia Severity Index: ISI) data were collected from 22 middle-aged pID patients and 22 good-sleepers. Patients underwent overnight polysomnography.Results: Compared to good-sleepers, patients had lower overall cognitive performance (average: 24.6 versus 26.3 points, Mann–Whitney U = 136.5, p = < 0.006), with deficits in clock drawing and verbal abstraction. In patients, poorer overall cognitive performance correlated with reduced subjective sleep quality (PSQI: r(42) = − 0.47, p = 0.001; and ISI: r(42) = − 0.43, p = 0.004), reduced objective sleep quality (lower sleep efficiency: r(20) = 0.59, p = 0.004 and less REM-sleep: r(20) = 0.52, p = 0.013; and increased sleep latency: r(20) = − 0.57, p = 0.005 and time awake: r(20) = − 0.59, p = 0.004). Cognitive performance was not related to anxiety/depression scores.Conclusion: Using a simple neurocognitive screening tool, we found that pID patients showed cognitive deficiencies that related to both subjective/self-reported and objective/polysomnographic measures of sleep quality. Furthermore, these cognitive changes resembled those seen in preclinical non-amnestic AD, and thus could indicate incumbent neurodegenerative processes in pID. Interestingly, increased REM-sleep was correlated with better cognitive performance. However, whether REM-sleep is protective against neurodegeneration requires further investigation.Keywords: insomnia, sleep, neurodegeneration, Alzheimer’s disease, polysomnography, cognitive screeninghttps://www.dovepress.com/the-relationship-between-cognitive-impairments-and-sleep-quality-measu-peer-reviewed-fulltext-article-NSSinsomniasleepneurodegenerationalzheimer’s diseasepolysomnographycognitive screening |
| spellingShingle | Künstler ECS Bublak P Finke K Koranyi N Meinhard M Schwab M Rupprecht S The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder Nature and Science of Sleep insomnia sleep neurodegeneration alzheimer’s disease polysomnography cognitive screening |
| title | The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder |
| title_full | The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder |
| title_fullStr | The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder |
| title_full_unstemmed | The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder |
| title_short | The Relationship Between Cognitive Impairments and Sleep Quality Measures in Persistent Insomnia Disorder |
| title_sort | relationship between cognitive impairments and sleep quality measures in persistent insomnia disorder |
| topic | insomnia sleep neurodegeneration alzheimer’s disease polysomnography cognitive screening |
| url | https://www.dovepress.com/the-relationship-between-cognitive-impairments-and-sleep-quality-measu-peer-reviewed-fulltext-article-NSS |
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