Sleep disturbance and cognitive decline in individuals aged 25–44

Objective: to establish associations between the level of sleep disturbances (SD) and cognitive decline (CD; patterns of memory, attention, and executive functions) in individuals aged 25–44 years.

Material and methods. In 2013–2016, a survey of a random representative sample of individuals aged 25–44 was conducted in one of the districts of Novosibirsk under the World Health Organisation's MOPSY (MONICA-psychosocial) programme. The level of SD and the state of cognitive functions (CF) were assessed in 713 people (325 men and 388 women; average age – 36.17±5.99 years) according to the criteria of the World Health Organisation's MOPSY (MONICA-psychosocial) programme. Standardised tests were used to assess CF.

Results. In a random representative sample of individuals aged 25–44, the prevalence of sleep disorders was higher among women than men (46.4% versus 40.1%, respectively). At the same time, the subjective assessment of sleep by respondents was as follows: 'satisfactory' – 35.6% and 35.5%, “poor” – 10.3% and 4.3%, 'very poor' – 0.5% and 0.3% in women and men, respectively (χ²=10.482; df=4; p<0.033). It was found that when sleep was poor, men were able to name only 7.5476±1.20973 words during direct word recall in the 10-word memorization test of A.R. Luria, with satisfactory sleep – 7.5948±1.17612 words, and with good and very good sleep, they named 7.9956±0.84677 and 7.9923±0.94697 words, respectively (χ²=10.114; df=5; p=0.039). It was found that with poor sleep, men were able to view only 251.64±82.822 letters of the proofreading test in 1 minute, with satisfactory sleep – 288.36±73.961 letters. The best results for this indicator were achieved by men without SD, who were able to view 303.91±70.292 letters in 1 minute in the case of good sleep and 319.7±61.577 letters in the case of very good sleep (χ²=19.012; df=5; p=0.001). Women with sleep disturbances were able to recall 8.63±1.125 words during delayed reproduction of 10 words after an interfering task, while those with satisfactory sleep recalled 8.38±1.347 words. The best results in this test were achieved by women without SD, who were able to recall 8.76±1.387 words after good sleep and 8.69±1.398 words after very good sleep (χ²=12.264; df=5; p=0.015).

Conclusion. A population study has established an association between sleep disturbances and cognitive decline (memory, attention and executive functions patterns) in individuals aged 25–44.

1. Li C, Ford ES, Zhao G, et al. Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005-2006. Prev Med. 2010 Jul;51(1):18-23. doi: 10.1016/j.ypmed.2010.03.016

2. Pandi-Perumal SR, Verster JC, Kayumov L, et al. Sleep disorders, sleepiness and traffic safety: a public health menace. Braz J Med Biol Res. 2006 Jul;39(7):863-71. doi: 10.1590/s0100-879x2006000700003

3. Ferrie JE, Kumari M, Salo P, et al. Sleep epidemiology – a rapidly growing field. Int J Epidemiol. 2011 Dec;40(6):1431-7. doi: 10.1093/ije/dyr203

4. Rowshan Ravan A, Bengtsson C, Lissner L, et al. Thirty-six-year secular trends in sleep duration and sleep satisfaction, and associations with mental stress and socioeconomic factors – results of the Population Study of Women in Gothenburg, Sweden. J Sleep Res. 2010 Sep;19(3):496-503. doi: 10.1111/j.1365-2869.2009.00815.x

5. Ford ES, Cunningham TJ, Croft JB. Trends in Self-Reported Sleep Duration among US Adults from 1985 to 2012. Sleep. 2015 May 1;38(5):829-32. doi: 10.5665/sleep.4684

6. Sharma VK, Subramanian SK, Vinayathan A, et al. Study the effect of age and gender related differences on common paper and pencil neurocognitive tests in adolescents. J Clin Diagn Res. 2014 Nov;8(11):BC05-10. doi: 10.7860/JCDR/2014/10727.5080

7. Joo EY, Kim H, Suh S, Hong SB. Hippocampal substructural vulnerability to sleep disturbance and cognitive impairment in patients with chronic primary insomnia: magnetic resonance imaging morphometry. Sleep. 2014;37(7):1189-98. doi: 10.5665/sleep.3836

8. Zakharov VV. Risk factors and prevention of cognitive impairment in elderly people. S.S. Korsakov Journal of Neurology and Psychiatry. 2012;112(8):86-91. (In Russ.)

9. Sukhanov AV, Voevoda MI, Gromova EA, et al. Cognitive functions and professional status in the open population of Russia/Siberia among adults aged 25–44 years. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(2):26-34. (In Russ.) doi.: 10.14412/2074-2711-2022-2-26-34

10. Cardinali DP, Brusco LI, Liberczuk C, Furio AM. The use of melatonin in Alzheimer's disease. Neuro Endocrinol Lett. 2002 Apr;23 Suppl 1:20-3.

11. Magomedova KA, Poluectov MG. Characteristics of sleep disorders among elderly patients. Medical and Social Expert Evaluation and Rehabilitation. 2013;16(3):44-6. (In Russ.) doi: 10.17816/MSER35797

12. Cardinali DP, Srinivasan V, Brzezinski A, Brown GM. Melatonin and its analogs in insomnia and depression. J Pineal Res. 2012;52(4):365-75. doi: 10.1111/j.1600-079X.2011.00962.x

13. Sukhanov AV, Denisova DV. Associations of blood pressure, heart rate and cognitive function in the adolescents: A population-based study. Arterial Hypertension. 2010;16(4):378-84. (In Russ.) doi: 10.18705/1607-419X-2010-16-4-378-384

14. Gafarov VV, Sukhanov AV, Gromova EA, et al. Depression as an independent risk factor for cardiovascular diseases and cognitive impairment in people aged 25–44 years. Cardiovascular Therapy and Prevention. 2024;23(5):3930. (In Russ.) doi: 10.15829/1728-8800-2024-3930. EDN:BGZWQW

15. Peasey A, Bobak M, Kubinova R, et al. Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: rationale and design of the HAPIEE study. BMC Pub Health.2006;6:255. doi: 10.1186/1471-2458-6-255

16. Gafarov VV, Gromova EA, Panov DO, et al. Sleep disorder trends in 1988–2018 among the 25–64 years old population in Russia/Siberia (WHO MONICA Psychosocial study). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(3):42-7. (In Russ.) doi: 10.14412/2074-2711-2021-3-42-47

17. Gentleman R. R programming for bioinformatics. In: Chapman & Hall/CRC computer science and data analysis series. Boca Raton: CRC Press; 2009. 314 p.

18. Glanz S. Medical and biological statistics. Translated from English. Moscow: Praktika; 1999. 460 p. (In Russ.)

19. Preobrazhenskaya IS. Sleep disorders and their significance in the development of cognitive impairments. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;5(4):49-53. (In Russ.) doi: 10.14412/2074-2711-2013-2455

20. Schutte-Rodin S, Broch L, Buysse D, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008 Oct 15;4(5):487-504.

21. Golenkov AV, Poluektov MG. Prevalence of sleep disorders in citizens of Chuvash Republic (results from complete interview study). S.S. Korsakov Journal of Neurology and Psychiatry. 2011;111(6):64-7. (In Russ.)

22. Kovrov GV, Lebedev MA, Palatov SYu. Modern approaches to the treatment of insomnia. Medical Council. 2013;(4):42-7. (In Russ.) doi: 10.21518/2079-701X-2013-4-42-47

23. Nagai M, Hoshide S, Kario K. Sleep duration as a risk factor for cardiovascular disease – a review of the recent literature. Curr Cardiol Rev. 2010 Feb;6(1):54-61. doi: 10.2174/157340310790231635

24. Sukhanov AV, Denisova DV, Gafarov VV. The influence of arterial hypertension on the state of cognitive functions in individuals aged 14–17 and 25–44 years. Ateroscleroz. 2023;19(3):243-5. (In Russ.) doi: 10.52727/2078-256X-2023-19-3-243-245

25. Robillard R, Lanfranchi PA, Prince F, et al. Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge. Sleep. 2011 Mar 1;34(3):335-9. doi: 10.1093/sleep/34.3.335

26. Bochkarev MV, Korostovtseva LS, Filchenko IA, et al. Social-demographic aspects of insomnia in the Russian population according to ESSE-RF study. S.S. Korsakov Journal of Neurology and Psychiatry. 2018;118(4-2):26-34. (In Russ.) doi: 10.17116/jnevro20181184226

27. Fortier-Brochu E, Beaulieu-Bonneau S, Ivers H, Morin CM. Insomnia and daytime cognitive performance: a meta-analysis. Sleep Med Rev. 2012 Feb;16(1):83-94. doi: 10.1016/j.smrv.2011.03.008

28. Noh HJ, Joo EY, Kim ST, et al. The relationship between hippocampal volume and cognition in patients with chronic primary insomnia. J Clin Neurol. 2012 Jun;8(2):130-8. doi: 10.3988/jcn.2012.8.2.130

29. Yang Q, Li S, Yang Y, et al. Prolonged sleep duration as a predictor of cognitive decline: A meta-analysis encompassing 49 cohort studies. Neurosci Biobehav Rev. 2024;164:105817. doi: 10.1016/j.neubiorev.2024.105817

30. Zhang X, Yin J, Sun X, et al. The association between insomnia and cognitive decline: A scoping review. Sleep Med. 2024;124:540-50. doi: 10.1016/j.sleep.2024.10.021

31. Wu F, Li X, Guo YN, et al. Effects of insomnia treatments on cognitive function: A meta-analysis of randomized controlled trials. Psychiatry Res. 2024;342:116236. doi: 10.1016/j.psychres.2024.116236