Sleep Fragmentation, Cerebral Arteriolosclerosis, and Brain Infarct Pathology in Community-Dwelling Older People

Stroke. 2016 Feb;47(2):516-8. doi: 10.1161/STROKEAHA.115.011608. Epub 2016 Jan 14.

Abstract

Background and purpose: Although several forms of sleep disruption are associated with stroke, few studies have examined the relationship between sleep and histopathologic measures of cerebrovascular disease. We tested the hypothesis that greater sleep fragmentation is associated with a higher burden of cerebral vessel and infarct pathology at autopsy.

Methods: We used ordinal logistic regression models to relate sleep fragmentation measured by actigraphy to the severity of arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy, and the number of macroscopic and microscopic infarcts assessed by structured brain autopsy in 315 participants from the Rush Memory and Aging Project.

Results: Greater sleep fragmentation was associated with more severe arteriolosclerosis (odds ratio, 1.27; 95% confidence interval, 1.02-1.59; P=0.03 per 1 SD greater sleep fragmentation) and more subcortical macroscopic infarcts (odds ratio, 1.31; 95% confidence interval, 1.01-1.68; P=0.04). These associations were independent of established cardiovascular risk factors and diseases, and several medical comorbidities.

Conclusions: Sleep fragmentation is associated with arteriolosclerosis and subcortical infarcts in older adults.

Keywords: arteriolosclerosis; cerebral infarct; histopathology; sleep; stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actigraphy
  • Aged, 80 and over
  • Arteriolosclerosis / epidemiology*
  • Arteriolosclerosis / pathology
  • Autopsy
  • Brain Infarction / epidemiology
  • Brain Infarction / pathology
  • Cerebral Amyloid Angiopathy / epidemiology*
  • Cerebral Amyloid Angiopathy / pathology
  • Cerebral Infarction / epidemiology*
  • Cerebral Infarction / pathology
  • Female
  • Humans
  • Independent Living
  • Intracranial Arteriosclerosis / epidemiology*
  • Intracranial Arteriosclerosis / pathology
  • Logistic Models
  • Male
  • Odds Ratio
  • Severity of Illness Index
  • Sleep Deprivation / epidemiology*