Daytime napping and Alzheimer's dementia: A potential bidirectional relationship

Gao, Lei; Yu, Lei; Zheng, Xi; Ulsa, Ma Cherrysse; Yang, Hao-Hsiang; Gaba, Arlen; Yaffe, Kristine; Bennett, David A.; Buchman, Aron S.; Hu, Kun; Leng, Yue

doi:10.1002/alz.12636

Cited by 61 publications

(66 citation statements)

References 47 publications

(76 reference statements)

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“…A recent study found that older adults tended to nap longer and more frequently with aging using objective actigraphy data. 27 The measurement difference and the age difference between their sample (81.42±7.47 years old) and ours (55.30±8.15 years old) might be the causes of this discrepancy. Thus, we conducted a simple test to investigate the association between baseline age and follow-up nap frequency change, as shown in Table S13.…”

Section: Discussioncontrasting

confidence: 52%

Association of Nap Frequency With Hypertension or Ischemic Stroke Supported by Prospective Cohort Data and Mendelian Randomization in Predominantly Middle-Aged European Subjects

et al. 2022

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Background and Purpose: The aim of this study was to investigate the association between daytime napping frequency and the incidence of essential hypertension or stroke as well as to validate causality in this relationship via Mendelian randomization (MR). Methods: We conducted Cox regression analysis on 358 451 participants free of hypertension or stroke from UK Biobank. To validate the results of the observational analysis, we conducted a 2-sample MR for daytime napping frequency (123 single-nucleotide polymorphisms) with essential hypertension in FinnGen Biobank, stroke, and ischemic stroke in MEGASTROKE consortium and performed a corresponding 1-sample MR on the UK Biobank data. Results: Compared with never napping, usually napping was associated with a higher risk of essential hypertension (hazard ratio, 1.12 [95% CI, 1.08–1.17]), stroke (hazard ratio, 1.24 [95% CI, 1.10–1.39], and ischemic stroke (hazard ratio, 1.20 [95% CI, 1.05–1.36]) in our prospective observational analysis. Both the 1-sample and 2-sample MR results indicated that increased daytime napping frequency was likely to be a potential causal risk factor for essential hypertension in FinnGEN (odds ratio, 1.43 [95% CI, 1.06–1.92]) and UK Biobank (odds ratio, 1.40 [95% CI, 1.28–1.58]). The 2-sample MR results supported the potential causal effect of nap frequency on ischemic stroke in MEGASTROKE (odds ratio, 1.29 [95% CI, 1.04–1.62]). Conclusions: Prospective observational and MR analyses provided evidence that increased daytime nap frequency may represent a potential causal risk factor for essential hypertension. The potential causal association of increased nap frequency with ischemic stroke was supported by 2-sample MR and prospective observational results.

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Section: Discussioncontrasting

confidence: 52%

Association of Nap Frequency With Hypertension or Ischemic Stroke Supported by Prospective Cohort Data and Mendelian Randomization in Predominantly Middle-Aged European Subjects

et al. 2022

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“…Meanwhile, a study showed that people with cognitive impairment had higher levels of CRP ( 49 ). In terms of nap duration, a study reported that excessive daytime naps and Alzheimer's dementia may have a bidirectional relationship or share common pathophysiological mechanisms ( 24 ). In addition, longer nap duration generally resulted in more sleep inertia ( 50 ), which resulted in decreased ability to think and perform ( 51 ).…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that various factors are associated with cognitive frailty, such as physical activity ( 19 ) and nutrition ( 20 ). Moreover, many studies have shown that both physical frailty and cognitive impairment are associated with sleep status, including sleep quality ( 21 , 22 ) and nap duration ( 23 , 24 ). There are still insufficient studies related to the association between sleep status and cognitive frailty, except for a study on the association of nighttime sleep duration with cognitive frailty among community-dwelling older adults in 2021 ( 25 ).…”

Section: Introductionmentioning

confidence: 99%

Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes

Liu

Zhao

Guo

et al. 2022

Front. Public Health

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BackgroundSleep status, including sleep quality and nap duration, may be associated with frailty and cognitive impairment in older adults. Older adults living in nursing homes may be more prone to physical and cognitive frailties. This study aimed to investigate the association between sleep quality and nap duration, and cognitive frailty among older adults living in nursing homes.MethodsThis study included 1,206 older adults aged ≥ 60 years from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used and Mini-Mental State Examination was conducted to assess physical frailty and cognitive impairment, respectively, to confirm cognitive frailty. The Pittsburgh Sleep Quality Index was used to assess the sleep quality. Nap duration was classified as follows: no, short (≤30 min), and long (>30 min) napping. Multinomial logistic regression was conducted to estimate the odds ratio (OR) and 95% confidence interval (CI).ResultsThe prevalence of cognitive frailty among the older adults in nursing homes was 17.5%. Approximately 60.9% of the older adults had a poor sleep quality. Among the 1,206 participants, 43.9% did not take naps, 29.1% had short naps, and 26.9% had long naps. After adjusting for all covariates, poor sleep quality (OR 2.53; 95% CI 1.78–3.59; P < 0.001) and long nap duration (OR 1.77; 95% CI 1.19–2.64; P = 0.003) were associated with higher odds of cognitive frailty, but short nap duration (OR 0.60; 95% CI 0.40–0.89; P = 0.012) was associated with low prevalence of cognitive frailty.ConclusionPoor sleep quality and long nap duration are significantly associated with high risk of cognitive frailty among the older adults in nursing homes. Short nap duration was associated with low prevalence of cognitive frailty. However, these associations require further validation in older adults.Clinical trial registrationhttps://osf.io/57hv8.

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“…These findings provide a hitherto underappreciated link between myelination and healthy sleep function, a connection that may be relevant to a range of neurological diseases. In mice, sleep fragmentation increases with age ( 45 ) and excessive sleep fragmentation is common in age-related disorders like Alzheimer’s disease ( 46 ), a disorder associated with deficits in oligodendrocytes and myelin ( 47 ). Numerous lines of evidence support that altered circadian biology is also significantly associated with MS prevalence.…”

Section: Discussionmentioning

confidence: 99%

BMAL1 loss in oligodendroglial lineage cells dysregulates myelination and sleep

Rojo

Badner

Cengio

et al. 2022

Preprint

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Myelination depends on maintenance of oligodendrocytes that arise from oligodendrocyte precursor cells (OPCs). We show that the dynamic nature of oligodendroglia and myelination are regulated by the circadian transcription factor BMAL1. Bmal1 knockdown in OPCs during development – but not adulthood – decreases OPC proliferation, whereas BMAL1 regulates OPC morphology throughout life. OPC-specific Bmal1 deficiency impairs remyelination in an age-dependent manner, suggesting that age-associated decrements in circadian regulation of oligodendroglia may contribute to the deficient remyelination potential in demyelinating diseases like multiple sclerosis (MS). This oligodendroglial dysregulation and dysmyelination increase sleep fragmentation in OPC-specific Bmal1 knockout mice, and sleep fragmentation is causally associated with MS. These findings have broad mechanistic and therapeutic implications for numerous brain disorders that include both myelin and sleep phenotypes.One-Sentence SummaryBMAL1 regulates the homeostatic maintenance of oligodendroglia and myelin, that subsequently controls sleep architecture.

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Daytime napping and Alzheimer's dementia: A potential bidirectional relationship

Cited by 61 publications

References 47 publications

Association of Nap Frequency With Hypertension or Ischemic Stroke Supported by Prospective Cohort Data and Mendelian Randomization in Predominantly Middle-Aged European Subjects

Association of Nap Frequency With Hypertension or Ischemic Stroke Supported by Prospective Cohort Data and Mendelian Randomization in Predominantly Middle-Aged European Subjects

Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes

BMAL1 loss in oligodendroglial lineage cells dysregulates myelination and sleep

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