Suboptimal self-reported sleep efficiency and duration are associated with faster accumulation of brain amyloid beta in cognitively unimpaired older adults

Louise N Pivac; Belinda M Brown; Kelsey R Sewell; James D Doecke; Victor L Villemagne; Vincent Doré; Michael Weinborn; Hamid R Sohrabi; Samantha L Gardener; Romola S Bucks; Simon M Laws; Kevin Taddei; Paul Maruff; Colin L Masters; Christopher Rowe; Ralph N Martins; Stephanie R Rainey-Smith

doi:10.1002/dad2.12579

Suboptimal self-reported sleep efficiency and duration are associated with faster accumulation of brain amyloid beta in cognitively unimpaired older adults

Alzheimers Dement (Amst). 2024 Apr 22;16(2):e12579. doi: 10.1002/dad2.12579. eCollection 2024 Apr-Jun.

Authors

Louise N Pivac^{1

2}, Belinda M Brown¹, Kelsey R Sewell¹, James D Doecke³, Victor L Villemagne⁴, Vincent Doré^{3

5}, Michael Weinborn⁶, Hamid R Sohrabi¹, Samantha L Gardener⁷, Romola S Bucks^{6

8}, Simon M Laws^{7

9

10

11}, Kevin Taddei⁷, Paul Maruff^{12

13}, Colin L Masters¹³, Christopher Rowe^{5

13}, Ralph N Martins^{7

14}, Stephanie R Rainey-Smith^{1

2

6

7}

Affiliations

¹ Centre for Healthy Ageing, Health Futures Institute Murdoch University Murdoch Western Australia Australia.
² Alzheimer's Research Australia, Sarich Neuroscience Research Institute Nedlands Western Australia Australia.
³ Australian E-Health Research Centre, CSIRO Herston Queensland Australia.
⁴ Department of Psychiatry University of Pittsburgh Pittsburgh Pennsylvania USA.
⁵ Department of Molecular Imaging Austin Health Heidelberg Victoria Australia.
⁶ School of Psychological Science University of Western Australia Perth Western Australia Australia.
⁷ School of Medical and Health Sciences Edith Cowan University Joondalup Western Australia Australia.
⁸ School of Population and Global Health University of Western Australia Perth Western Australia Australia.
⁹ Centre for Precision Health Edith Cowan University Joondalup Western Australia Australia.
¹⁰ Collaborative Genomics and Translation Group Edith Cowan University Joondalup Western Australia Australia.
¹¹ Curtin Medical School Curtin University Bentley Western Australia Australia.
¹² Cogstate Ltd., Melbourne Melbourne Victoria Australia.
¹³ The Florey Institute of Neuroscience and Mental Health University of Melbourne Melbourne Victoria Australia.
¹⁴ Department of Biomedical Sciences Macquarie University Macquarie University Sydney New South Wales Australia.

Abstract

Introduction: This study investigated whether self-reported sleep quality is associated with brain amyloid beta (Aβ) accumulation.

Methods: Linear mixed effect model analyses were conducted for 189 cognitively unimpaired (CU) older adults (mean ± standard deviation 74.0 ± 6.2; 53.2% female), with baseline self-reported sleep data, and positron emission tomography-determined brain Aβ measured over a minimum of three time points (range 33.3-72.7 months). Analyses included random slopes and intercepts, interaction for apolipoprotein E (APOE) ε4 allele status, and time, adjusting for sex and baseline age.

Results: Sleep duration <6 hours, in APOE ε4 carriers, and sleep efficiency <65%, in the whole sample and APOE ε4 non-carriers, is associated with faster accumulation of brain Aβ.

Discussion: These findings suggest a role for self-reported suboptimal sleep efficiency and duration in the accumulation of Alzheimer's disease (AD) neuropathology in CU individuals. Additionally, poor sleep efficiency represents a potential route via which individuals at lower genetic risk may progress to preclinical AD.

Highlights: In cognitively unimpaired older adults self-report sleep is associated with brain amyloid beta (Aβ) accumulation.Across sleep characteristics, this relationship differs by apolipoprotein E (APOE) genotype.Sleep duration <6 hours is associated with faster brain Aβ accumulation in APOE ε4 carriers.Sleep efficiency < 65% is associated with faster brain Aβ accumulation in APOE ε4 non-carriers.Personalized sleep interventions should be studied for potential to slow Aβ accumulation.

Keywords: AIBL study; Alzheimer's disease; amyloid; apolipoprotein E ε4; positron emission tomography; sleep.