Insomnia and daytime neuropsychological test performance in older adults

Ling, Audrey; Lim, May Li; Gwee, Xinyi; Ho, Roger; Collinson, Simon L.; Ng, Tze‐Pin

doi:10.1016/j.sleep.2015.07.037

Cited by 39 publications

(34 citation statements)

References 40 publications

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“…16,24 Clearly our study stands apart with respect to sample size and ability to control for the influence of multiple confounding sleep and non-sleep variables. The apparent small, but statistical advantage of those with insomnia versus those without was unexpected and is unlikely to be clinically meaningful [note, effect size differences in SD units = .044 (reasoning), .035 (reaction time) and .022 (visual memory)].…”

Section: Discussionmentioning

confidence: 99%

“…We could not investigate subtypes of insomnia that may have unique relationships with cognitive impairment. 16 Specifically, we were not able to categorise participants into insomnia disorder since we lacked information on chronicity of sleep problems, quantitative criteria (e.g. minutes for sleep-onset latency, wake-time during the night), attribution for daytime cognitive impairment, or help-seeking.…”

Section: Discussionmentioning

confidence: 99%

“…Larger epidemiology-based studies of insomnia symptoms and cognitive performance similarly display mixed results: showing evidence of impairment, 16 no evidence of impairment, 17 or impairment only for specific insomnia sub-groups. 15,18 To our knowledge, no study has investigated insomnia symptoms and cognitive performance in a large population-based sample of middle-aged adults, with a standardised test battery, while simultaneously appraising the influence of other important sleep variables, including chronotype, sleep duration, and sleep medication.…”

Section: Introductionmentioning

confidence: 99%

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Sleep and cognitive performance: cross-sectional associations in the UK Biobank

et al. 2017

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Objective The relationship between insomnia symptoms and cognitive performance is unclear, particularly at the population level. We conducted the largest examination of this association to date through analysis of the UK Biobank, a large population-based sample of adults aged 40–69 yrs. We also sought to determine associations between cognitive performance and self-reported chronotype, sleep medication use, and sleep duration. Methods This cross-sectional, population-based study involved 477,529 participants, comprising 133,314 with frequent insomnia symptoms (age: 57.4 ± 7.7 yrs; 62.1% female) and 344,215 controls without (age: 56.1 ± 8.2 yrs; 52.0% female). Cognitive performance was assessed through a touchscreen test battery probing reasoning, basic reaction time, numeric memory, visual memory and prospective memory. Adjusted models included relevant demographic, clinical and sleep variables. Results Frequent insomnia symptoms were associated with cognitive impairment in unadjusted models, however these effects were reversed after full adjustment, leaving those with frequent insomnia symptoms showing statistically better cognitive performance over those without. Relative to intermediate chronotype, evening chronotype was associated with superior task performance, while morning chronotype was associated with the poorest performance. Sleep medication use and both long (>9hrs) and short (<7hrs) sleep duration were associated with impaired performance. Conclusions Our results suggest that after adjustment for potential confounding variables, frequent insomnia symptoms may be associated with a small statistical advantage, which is unlikely to be clinically meaningful, on simple neurocognitive tasks. Further work is required to examine mechanistic underpinnings of an apparent evening chronotype advantage in cognitive performance, as well as impairment associated with morning chronotype, sleep medication use, and sleep duration extremes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sleep and cognitive performance: cross-sectional associations in the UK Biobank

et al. 2017

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“…One question was “difficulty falling asleep within 30 min”, which previously has been used as an insomnia indicator [5, 54, 55]. The second question was “difficulty falling asleep”, which has also been previously used as an insomnia indicator in previous studies [56–58], and was analyzed both as a categorical and as a binary variable. The third question (“number of min it takes to fall asleep”) we analyzed was a continuous variable, which has been previously used as an insomnia marker in several other studies [59–61].…”

Section: Methodsmentioning

confidence: 99%

Sleep onset insomnia, daytime sleepiness and sleep duration in relationship toToxoplasma gondiiIgG seropositivity and serointensity

et al. 2017

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AbstractToxoplasma gondii (T. gondii) infects central nervous tissue and is kept in relative dormancy by a healthy immune system. Sleep disturbances have been found to precipitate mental illness, suicidal behavior and car accidents, which have been previously linked to T. gondii as well. We speculated that if sleep disruption, particularly insomnia, would mediate, at least partly, the link between T. gondii infection and related behavioral dysregulation, then we would be able to identify significant associations between sleep disruption and T. gondii. The mechanisms for such an association may involve dopamine (DA) production by T. gondii, or collateral effects of immune activation necessary to keep T. gondii in check. Sleep questionnaires from 2031 Old Order Amish were analyzed in relationship to T. gondii-IgG antibodies measured by enzyme-linked immunosorbent assay (ELISA). Toxoplasma gondii seropositivity and serointensity were not associated with any of the sleep latency variables or Epworth Sleepiness Scale (ESS). A secondary analysis identified, after adjustment for age group, a statistical trend toward shorter sleep duration in seropositive men (p=0.07). In conclusion, it is unlikely that sleep disruption mediates links between T. gondii and mental illness or behavioral dysregulation. Trending gender differences in associations between T. gondii and shorter sleep need further investigation.

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“…One question was "difficulty falling asleep within 30 min", which previously has been used as an insomnia indicator [5,54,55]. The second question was "difficulty falling asleep", which has also been previously used as an insomnia indicator in previous studies [56][57][58], and was analyzed both as a categorical and as a binary variable. The third question ("number of min it takes to fall asleep") we analyzed was a continuous variable, which has been previously used as an insomnia marker in several other studies [59][60][61].…”

Section: Methodsmentioning

confidence: 99%

302. Sleep Onset Insomnia, Daytime Sleepiness and Sleep Duration in Relationship to Toxoplasma gondii IgG Seropositivity and Serointensity

Moustafa

Ahmad

Stiller

et al. 2017

Biological Psychiatry

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Toxoplasma gondii (T. gondii) infects central nervous tissue and is kept in relative dormancy by a healthy immune system. Sleep disturbances have been found to precipitate mental illness, suicidal behavior and car accidents, which have been previously linked to T. gondii as well. We speculated that if sleep disruption, particularly insomnia, would mediate, at least partly, the link between T. gondii infection and related behavioral dysregulation, then we would be able to identify significant associations between sleep disruption and T. gondii. The mechanisms for such an association may involve dopamine (DA) production by T. gondii, or collateral effects of immune activation necessary to keep T. gondii in check. Sleep questionnaires from 2031 Old Order Amish were analyzed in relationship to T. gondii-IgG antibodies measured by enzyme-linked immunosorbent assay (ELISA). Toxoplasma gondii seropositivity and serointensity were not associated with any of the sleep latency variables or Epworth Sleepiness Scale (ESS). A secondary analysis identified, after adjustment for age group, a statistical trend toward shorter sleep duration in seropositive men (p = 0.07). In conclusion, it is unlikely that sleep disruption mediates links between T. gondii and mental illness or behavioral dysregulation. Trending gender differences in associations between T. gondii and shorter sleep need further investigation. Ahmad et al.

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Insomnia and daytime neuropsychological test performance in older adults

Cited by 39 publications

References 40 publications

Sleep and cognitive performance: cross-sectional associations in the UK Biobank

Sleep and cognitive performance: cross-sectional associations in the UK Biobank

Sleep onset insomnia, daytime sleepiness and sleep duration in relationship toToxoplasma gondiiIgG seropositivity and serointensity

302. Sleep Onset Insomnia, Daytime Sleepiness and Sleep Duration in Relationship to Toxoplasma gondii IgG Seropositivity and Serointensity

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