Polysomnographic abnormalities in patients with vascular cognitive impairment-no dementia

• Published in: Sleep medicine Vol. 14; no. 11; pp. 1071 - 1075
• Main Authors: Jiang, Bo, Ding, Chengyun, Yao, Guoen, Yao, Cunshan, Zhang, Yunyan, Ge, Junling, Qiu, Enchao, Elia, Maurizio, Ferri, Raffaele
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.11.2013
• Subjects: Adult; Cerebrovascular Disorders - complications; Cerebrovascular Disorders - physiopathology; Cognition - physiology; Cognition Disorders - complications; Cognition Disorders - physiopathology; Dementia; Executive Function - physiology; Female; Humans; Male; Middle Aged; Neurology; Polysomnography; Sleep disorder; Sleep Medicine; Sleep quality; Sleep Stages - physiology; Sleep structure; Sleep Wake Disorders - etiology; Sleep Wake Disorders - physiopathology; Stroke - complications; Stroke - physiopathology; Vascular cognitive impairment-no dementia; Sleep disorder; Sleep quality; Polysomnography; Vascular cognitive impairment-no dementia; Dementia; Sleep structure
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2013.07.003

Abstract Objectives We aimed to investigate subjective sleep quality and polysomnographic sleep structure features in patients with vascular cognitive impairment-no dementia (VCIND). Methods Fifty-six patients with VCIND, 48 patients with simple stroke (without cognitive impairment), and 48 control subjects were included. The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to analyze their sleep characteristics. The Montreal Cognitive Assessment (MoCA) was conducted to assess mental state. Results Patients with VCIND had higher PSQI scores compared with control subjects and simple stroke patients ( P < .01). PSG revealed that patients with VCIND or stroke were more likely to experience prolonged sleep latency (SL), decreased sleep efficiency (SE), increased arousal, and reduced deep sleep and rapid eye movement (REM) sleep than controls. Patients with VCIND had significantly longer SL, increased periodic leg movements in sleep (PLMS), decreased SE, and increased arousal and sleep fragmentation compared to patients with simple stroke ( P < .05). In VCIND patients, a significant positive correlation was found between SE and MoCA scores ( r = 0.632; P < .001), though PSQI, SL, and arousal index were significantly negatively associated with MoCA scores ( r = −0.787, −0.740, −0.772, respectively; P < .001 for all). Conclusions VCIND patients had different abnormal sleep features, including decreased SE, increased PLMS, and prolonged SL and sleep fragmentation. Abnormal sleep in VCIND may be associated with cognitive impairment.