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Andrew S.P. Lim, Debra A. Fleischman, Robert J. Dawe, Lei Yu, Konstantinos Arfanakis, Aron S. Buchman, David A. Bennett, Regional Neocortical Gray Matter Structure and Sleep Fragmentation in Older Adults, Sleep, Volume 39, Issue 1, January 2016, Pages 227–235, https://doi.org/10.5665/sleep.5354
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Abstract
To test the hypothesis that greater sleep fragmentation is associated with regionally decreased cortical gray matter volume in older community-dwelling adults without cognitive impairment.
We studied 141 community-dwelling older adults (median age 82.9; 73% female) without cognitive impairment or stroke, and not using sedative/hypnotic medications, participating in the Rush Memory and Aging Project. We quantified sleep fragmentation from 7 d of actigraphy using the metric kRA and related this to total cortical gray matter volume, and regional gray matter volume in 34 cortical regions quantified by automated segmentation of magnetic resonance imaging data. We determined statistical significance and accounted for multiple comparisons by empirically estimating the false discovery rate by permutation.
Lower total cortical gray matter volume was associated with higher sleep fragmentation (coefficient +0.23, standard error [SE] 0.11, P = 0.037). Lower gray matter volumes in four cortical regions were accompanied by higher sleep fragmentation with a false discovery rate <0.05: the left (coefficient +0.36, SE 0.10, P = 2.7 × 10−4) and right (coefficient +0.31, SE 0.10, P = 4.0 × 10−3) lateral orbitofrontal cortices, and the adjacent left (coefficient +0.31, SE 0.10, 5.4 × 10−4) and right (coefficient +0.39, SE 0.10, P = 1.2 × 10–4) inferior frontal gyri pars orbitalis. These associations were unchanged after accounting for age, sex, education, depression, cognitive function, and a number of medical comorbidities.
Lower cortical gray matter volume in the lateral orbitofrontal cortex and inferior frontal gyrus pars orbitalis is associated with greater sleep fragmentation in older community-dwelling adults. Further work is needed to clarify whether this is a consequence of or contributor to sleep fragmentation.
A commentary on this article appears in this issue on page 15.
Sleep fragmentation is a common symptom in older adults and is associated with a number of adverse health outcomes. Although identifiable sleep disorders contribute to fragmented sleep in some older adults, the biological basis of fragmented sleep in many individuals remains to be elucidated. Using wrist accelerometry and brain magnetic resonance imaging data from 141 older community-dwelling adults without cognitive impairment or stroke, we showed that lower cortical gray matter volume in two specific brain regions is associated with greater sleep fragmentation in older adults. These data suggest that lower cortical volumes in these regions may be an important contributor to or consequence of sleep fragmentation.
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