EXPRESS: Association between Neurovascular Network Dysfunction and Poor Sleep Quality in Patients with Cerebral Small...

Poor sleep quality is frequently reported among patients with cerebral small vessel disease (CSVD), but its neurovascular correlates remain unclear. We examined exploratory associations between multidomain neurovascular network (NVN) measures and poor sleep quality in patients with CSVD.

In this cross-sectional analysis nested within a prospective CSVD registry, 102 patients with CSVD underwent heart rate variability, cerebral haemodynamic and resting-state electroencephalography assessments. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index (PSQI) global score >5. Analyses were primarily adjusted for age and sex, with false discovery rate (FDR) correction applied across all evaluated NVN variables.

Fifty-three participants had poor sleep quality. Among 108 evaluated NVN variables, 12 showed nominal unadjusted between-group differences and 13 showed nominal age- and sex-adjusted associations with poor sleep quality. Neither crude nor adjusted associations survived FDR correction. In secondary exploratory model analyses, the multidomain NVN model showed an apparent area under the curve (AUC) of 0.795 and a bootstrap optimism-corrected AUC of 0.758.

PSQI-defined poor sleep quality in CSVD was accompanied by exploratory differences across autonomic, haemodynamic and neuroelectrical NVN domains. Longitudinal studies with non-CSVD controls and objective sleep assessments are needed.