Study finds strong association between altered sleep patterns and neurodegenerative diseases after 5 years.

The results of a study presented at EAN 2023 support the assumption that sleep changes contribute to the pathogenesis of neurodegenerative diseases (NDDs). Altered sleep architecture at baseline with reduced sleep efficiency, REM sleep or N3 sleep, or increased wake periods in sleep period time (SPT) was robustly associated with incident neurodegeneration after 5 years and more.

Abubaker Ibrahim, MD, explained that the aim of this retrospective cohort study was to investigate whether polysomnography-based sleep features are associated with the long-term risk of an NDD. The study comprised patients who were referred to the Sleep Disorders Unit of the Medical University Innsbruck from 2004 to 2007. The patients were 18 or older, underwent polysomnography, and did not show neurodegeneration at baseline and during the first 5 years of follow-up. Of 1,454 assessed patients, 999 met these criteria (31.7% women; median age, 54.9 years). Dr. Ibrahim and colleagues wanted to know how many patients of this core group would receive an NDD diagnosis before the year 2022.

After a median of 12.8 years of follow-up, 75 patients (7.5%) developed an NDD; 924 (92.5%) did not. Dr. Ibrahim said a 1% decrease in sleep efficiency, N3 sleep (ie, deep sleep), or REM sleep was associated with a 1.9%, 6.5%, and 5.2% increased risk of incident neurodegeneration, respectively (HRs, 1.019, 1.065, and 1.052, respectively), after adjusting for demographic, sleep, and clinical covariates. A 1% decrease in waking within the SPT corresponded with a 2.2% reduced risk of incident NDD (HR, 0.978). Participants in the highest wake-in-SPT quartile (>18.6%) or the lowest REM sleep (<13.0%) or N3 sleep (0%) quartile had the shortest overall mean disease-free survival (14.9 years; 95% CI, 14.6-15.3 years). Dr. Ibrahim explained, “Random forest analysis showed that wake followed by deep sleep and REM sleep was the strongest predictor of neurodegeneration.” He concluded that altered sleep architecture can be used as a marker of NDD, but perhaps also as a future target for neuroprotective strategies. “With this, I hope to have convinced you to have a good night’s sleep and to convince your patients to do the same.”

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