DOI: 10.1161/jaha.126.051940 ISSN: 2047-9980

Healthy Sleep Mitigates the Association Between Cardiometabolic Disease and Poorer Cognitive and Brain Health

Yuyang Miao, Livia Fingerson, Elise Walters, Kathryn DaSilva, Mariam Militonyan, Aleksandra Koycheva, Sakura Sakakibara, Charlotte Sørensen, Shireen Sindi, Abigail Dove
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Background

Cardiometabolic diseases (CMDs), including type 2 diabetes, heart disease, and stroke, are important risk factors for dementia. We examined whether healthy sleep can support cognitive and brain health in people with CMDs.

Methods

The study included data from 408 977 adults from the UK Biobank. CMDs were defined using medical records, medication use, and medical history. Sleep patterns were defined using a composite score incorporating sleep duration, chronotype, insomnia symptoms, snoring, and daytime sleepiness. A subsample (n=34 913) underwent brain magnetic resonance imaging; volumes of total brain, gray matter, white matter, hippocampus, and white matter hyperintensities were ascertained. Associations of joint CMD (yes/no) and sleep (healthy, intermediate, poor) status with global and domain‐specific cognitive scores and brain magnetic resonance imaging measures were examined using linear regression models.

Results

At baseline, 54017 (13.2%) participants had at least one CMD. In joint exposure analysis, performance in global cognition (β=0.02 [95% CI, 0.01–0.05]), verbal/numeric reasoning (β=0.07 [95% CI, 0.01–0.12]), and processing speed (β=0.07 [95% CI, 0.04–0.10]) was significantly higher among individuals with CMDs and a healthy sleep pattern, compared with those with CMDs and a poor sleep pattern. Similarly, in neuroimaging analyses, participants with CMDs and a healthy versus poor sleep pattern showed significantly larger total brain volume (β=0.22 [95% CI, 0.08–0.35]), gray matter volume (β=0.23 [95% CI, 0.09–0.36]), and white matter volume (β=0.19 [95% CI, 0.05–0.33]).

Conclusions

Healthy sleep may attenuate the associations of CMDs with poorer cognitive performance and markers of brain atrophy. The findings highlight sleep as a modifiable factor that may support cognitive and brain health in individuals with CMDs.

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