Multi-Dimensional Sleep Health and Aging-Related Chronic Disease Risk

National Institute On Aging

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Abstract

Growing evidence indicates that getting good sleep is essential for brain health and cognitive functions. However, existing studies have predominantly focused on individual sleep health dimensions such as sleep duration and sleep quality, but most people experience more than one type of sleep problem at the same time. To elucidate how overall sleep health relates to the risk of developing dementia, we followed over 313,000 adults aged 50 and older from the UK Biobank who were free of dementia at baseline. Multi-dimensional sleep health was assessed by seven self-reported sleep factors using both an empirical sleep health score and a data-driven approach. We found that people with the poorest sleep health score had a 76% higher risk of all-cause dementia compared with those with the healthiest sleep health score. The risks were especially strong for vascular dementia compared with Alzheimer’s disease. We also identified specific sleep health phenotypes associated with incident dementia risk, such as insomnia with short sleep duration, insomnia with non-restorative sleep, and snoring with daytime sleepiness and napping. The highest dementia risk was observed among people with multiple co-occurring adverse sleep health factors. These findings suggest that taking a holistic approach to sleep health, rather than focusing on individual sleep health dimensions, provides a clearer picture of its relationships with dementia risk and may help identify high-risk individuals to develop more targeted strategies for improving brain health and healthy aging. Ongoing work is integrating subjective and objective measures of sleep health with cognitive testing, proteomic biomarkers of neurodegeneration, and autopsy findings of brain lesions to further understand the mechanisms linking multi-dimensional sleep health to dementia risk.