Multidimensional Sleep Health and Cognitive Risk in Midlife Primary Care: Comparing Questionnaires

Area of Science:

• Neurology and Public Health
• Cognitive Science and Sleep Medicine

Background:

• Sleep-wake disturbances are prevalent in midlife and may impact long-term brain health.
• Primary care settings require efficient tools to detect early cognitive vulnerability associated with sleep issues.

Purpose of the Study:

• To assess the association between common sleep questionnaires and cognitive impairment in midlife primary care patients.
• To identify which sleep disturbance phenotypes reliably indicate early cognitive vulnerability.

Main Methods:

• A cross-sectional analysis of 646 midlife adults (35-64 years) from the MidCog cohort.
• Five sleep questionnaires evaluated distinct phenotypes: unsatisfactory sleep, short duration, OSA risk, insomnia, and poor multidimensional sleep health (RU-SATED).
• Cognitive impairment was measured using the NIH Toolbox Cognition Battery (NIHTB-CB) and Montreal Cognitive Assessment (MoCA).

Main Results:

• Cognitive impairment was present in 18.7% (NIHTB-CB) and 22.3% (MoCA) of participants.
• Only poor multidimensional sleep health (RU-SATED score ≤6) showed a consistent association with cognitive impairment.
• Adjusted odds ratios for cognitive impairment were 2.03 (NIHTB-CB) and 1.98 (MoCA) for poor multidimensional sleep health.

Conclusions:

• Poor multidimensional sleep health is significantly associated with cognitive impairment in midlife primary care patients.
• Brief screening for multidimensional sleep health can identify individuals at risk for cognitive vulnerability.
• Targeting sleep interventions based on multidimensional sleep health may promote long-term brain health.