Cognition and 20-year subsequent sleep disturbances

Nancy A. West, Dayna A. Johnson, Pamela L. Lutsey, Thomas H. Mosley, Susan Redline

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction: There is a paucity of data exploring the extent that preclinical cognitive changes are predictive of subsequent sleep outcomes. Methods: Logistic regression models were used to evaluate data from a cohort of 196 African American adults who had measures of cognitive function assessed at 2 time points during a 20-year period across the mid- to late-life transition. Cognitive testing included the Delayed Word Recall, the Digit Symbol Substitution, and the Word Fluency tests, which were summarized as a composite cognitive z-score. Sleep apnea was measured by in-home sleep apnea testing and sleep duration and quality were derived from 7-day wrist actigraphy at the end of the study period. Results: A one standard deviation (SD) lower composite cognitive z-score at baseline was significantly associated with greater odds of low sleep efficiency (<85%) (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.13, 3.04) and greater odds of increased wakefulness after sleep onset time (WASO; >60 minutes) (OR = 1.65, 95% CI = 1.05, 2.60) in adjusted models. A one SD faster rate of cognitive decline over the study period was significantly associated with greater odds of low sleep efficiency (OR = 1.68, 95% CI = 1.04, 2.73), greater odds of sleep fragmentation (>35%); (OR = 1.73, 95% CI = 1.05, 2.85), and greater odds of increased WASO (OR = 1.85, 95% CI = 1.15, 2.95) in adjusted models. Neither baseline cognitive z-score nor rate of cognitive decline was associated with sleep apnea or the total average sleep duration. Conclusion: Cognition at baseline and change over time predicts sleep quality and may reflect common neural mechanisms and vulnerabilities.

Original languageEnglish (US)
Pages (from-to)631-637
Number of pages7
JournalSleep Health
Issue number5
Early online dateMar 6 2021
StatePublished - Oct 2021

Bibliographical note

Funding Information:
This work was supported by the National Heart, Lung, and Blood Institute [ R01HL110068 ]. The Jackson Heart Study is supported and conducted in collaboration with Jackson State University [ HHSN268201800013I ], Tougaloo College [ HHSN268201800014I ], the Mississippi State Department of Health [ HHSN268201800015I ], and the University of Mississippi Medical Center HHSN268201800010I , HHSN268201800011I , and HHSN268201800012I contracts from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities . SR was supported in part by 5R35HL135818 and DJ was supported in part by K01HL138211 .

Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute , National Institutes of Health , and Department of Health and Human Services , under Contract nos. HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , and HHSN268201700004I .

Publisher Copyright:
© 2021 National Sleep Foundation


  • Cognition
  • Cognitive decline
  • Longitudinal analysis
  • Sleep
  • Sleep disturbances

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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