title: Sleep-disordered breathing and white matter disease in the brainstem in older adults.
abstract: OBJECTIVE
  To examine whether sleep-disordered breathing is associated with white matter disease in the brainstem.
  
  
  METHODS
  A population-based longitudinal study.
  
  
  METHODS
  Allegheny County, PA; Sacramento County, CA; and Washington County, MD.
  
  
  METHODS
  A total of 789 individuals, aged 68 years or older, drawn from the Sleep Heart Health Study.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  The participants underwent home polysomnography in 1995-1998 and cerebral magnetic resonance imaging in both 1992-1993 and 1997-1998. The apnea-hypopnea index was not associated with white matter disease in the brainstem, with or without adjusting for age, sex, race, community, body mass index, smoking status, alcohol use, systolic blood pressure, and the use of antihypertensive medication. In contrast, the arousal index (number of arousals per hour of sleep) was inversely associated with brainstem white matter disease (odds ratio = 0.75 for a SD increase in the arousal index, 95% confidence interval: 0.62, 0.92).
  
  
  CONCLUSIONS
  The frequency of apneas and hypopneas was not associated with brainstem white matter disease in these older adults. A unique relationship with arousal frequency suggests that ischemic changes in the brainstem may be associated with arousals during sleep.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. jding@jhsph.edu
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Nieto
authors.forename: Norman J
authors.initials: NJ
authors.lastname: Beauchamp
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: John A
authors.initials: JA
authors.lastname: Robbins
authors.forename: Jacqueline B
authors.initials: JB
authors.lastname: Hetmanski
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
mesh_terms: D000368:Aged; D001143:Arousal / Q000502:physiology; D001921:Brain / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology; D004585:Electrooculography; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D017286:Polysomnography; D011159:Population Surveillance / Q000379:methods; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology; D012894:Sleep Stages / Q000502:physiology