Display options
Cite
Yao CW, Pelletier A, Fereshtehnejad SM, et al. Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the CLSA. J Clin Sleep Med. 2021;doi: 10.5664/jcsm.9562.
Yao, C. W., Pelletier, A., Fereshtehnejad, S. M., Cross, N., Dang-Vu, T., & Postuma, R. B. (2021). Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the CLSA. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, . https://doi.org/10.5664/jcsm.9562
Yao, Chun W, et al. "Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the CLSA." Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. (2021). doi: https://doi.org/10.5664/jcsm.9562
Yao CW, Pelletier A, Fereshtehnejad SM, Cross N, Dang-Vu T, Postuma RB. Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the CLSA. J Clin Sleep Med. 2021 Jul 27; doi: 10.5664/jcsm.9562. Epub 2021 Jul 27. PMID: 34314348.
Copy Download .nbib Format: NLM
Share it on

J Clin Sleep Med. 2021 Jul 27; doi: 10.5664/jcsm.9562. Epub 2021 Jul 27.

Insomnia symptom subtypes and manifestations of prodromal neurodegeneration: a population-based study in the CLSA.

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

Chun W Yao, Amélie Pelletier, Seyed-Mohammad Fereshtehnejad, Nathan Cross, Thanh Dang-Vu, Ronald B Postuma

Affiliations

  1. Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada.
  2. Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
  3. Research center of the Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada.
  4. Division of Neurology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
  5. Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.
  6. PERFORM Centre, Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada.
  7. Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.

PMID: 34314348 DOI: 10.5664/jcsm.9562

Abstract

STUDY OBJECTIVES: To identify the association between insomnia symptoms and signs of prodromal neurodegeneration, including an analysis of potential differences between sleep-onset and sleep-maintenance insomnia.

METHODS: We included those aged 45-85 years, living in one of 10 Canadian provinces in between 2012-2015 (at the baseline), recruited via three population-based sampling methods. Insomnia symptoms were assessed using questions adapted/modified from the Pittsburgh Sleep Quality Index. A panel of potential prodromal neurodegenerative markers including self-reported symptoms and objective gait motor, cognitive, and autonomic variables were assessed cross-sectionally. We compared those who endorsed insomnia symptoms ≥3 times per week to controls, adjusting for age, sex and education via logistic regression.

RESULTS: Overall, 2,051/30,097 people screened positive for sleep-onset insomnia alone and 4,333 for sleep-maintenance insomnia alone, while 2,371 endorsed both subtypes. On objective gait tests, participants with sleep-onset insomnia, but not sleep-maintenance insomnia, had worse balance (OR = 1.33[1.16,1.52]) and slower gait speed (OR = 1.52[1.34,1.73]). Although participants with any insomnia subtype endorsed more motor symptoms, these were more severe in those with sleep-onset insomnia (OR onset vs. maintenance = 1.13 [1.07,1.18]). On objective cognitive tests, those with sleep-maintenance insomnia scored normally. However, participants with sleep-onset insomnia performed worse on tests of verbal fluency (OR = 1.24[1.06,1.43]) immediate memory (OR = 1.23[1.08,1.41]), and prospective memory task (OR = 1.29[1.11,1.50]). The sleep-onset insomnia group also had lower heart rate variability (OR = 1.23[1.07,1.43]). Secondary analyses found generally similar results in young vs. older age of insomnia development.

CONCLUSIONS: Compared to maintenance insomnia, those with sleep-onset insomnia have more motor, cognitive and autonomic signs/symptoms. When evaluating neurodegenerative risk, differentiating insomnia subtypes may increase precision.

© 2021 American Academy of Sleep Medicine.

Keywords: dementia; insomnia; movement disorder; neurodegeneration

Publication Types