title: Sleep duration is associated with white matter hyperintensity volume in older adults: the Northern Manhattan Study.
abstract: Self-reports of long or short sleep durations have indicated an association with cardiovascular morbidity and mortality, but there are limited data evaluating their association with white matter hyperintensity volume (WMHV), a marker of cerebral small vessel disease. We conducted a cross-sectional analysis of self-reported sleep duration to test for a correlation with white matter hyperintensities, measured by quantitative magnetic resonance imaging (MRI), in the Northern Manhattan Study. We used multivariable linear regression models to assess associations between both short (<6 h) and long (≥9 h) sleep durations and log-transformed WMHV, adjusting for demographic, behavioural and vascular risk factors. A total of 1244 participants, mean age 70 ± 9 years, 61% women and 68% Hispanics were analysed with magnetic resonance brain imaging and self-reported sleep duration. Short sleep was reported by 23% (n = 293) and long sleep by 10% (n = 121) of the sample. Long sleep (β = 0.178; P = 0.035), but not short sleep (β = -0.053; P = 0.357), was associated with greater log-WMHV in fully adjusted models. We observed an interaction between sleep duration, diabetes mellitus and log-WMHV (P = 0.07). In fully adjusted models, stratified analysis showed that long sleep duration was associated with greater WMHV only in those with diabetes (β = 0.78; P = 0.0314), but not in those without diabetes (β = 0.022; P = 0.2), whereas short sleep was not associated with white matter hyperintensities in those with or without diabetes. In conclusion, long sleep duration was associated with a greater burden of white matter lesions in this stroke-free urban sample. The association was seen mainly among those with diabetes mellitus.
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Alberto R
authors.initials: AR
authors.lastname: Ramos
authors.forename: Chuanhui
authors.initials: C
authors.lastname: Dong
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.forename: Bernadette
authors.initials: B
authors.lastname: Boden-Albala
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D012890:Sleep / Q000502:physiology*; D020521:Stroke; D013997:Time Factors; D066127:White Matter / Q000473:pathology*
keywords: diabetes; elderly; hyperintensities; leukoaraiosis; long sleep; multi-ethnic; short sleep; white matter