Nature and Science of Sleep (Apr 2022)

Association of Excessive Daytime Sleepiness with Cerebral Small Vessel Disease in Community-Dwelling Older Adults

  • Zhao J,
  • Kong Q,
  • Wang M,
  • Huang H,
  • Zhou X,
  • Guo Y,
  • Zhang Y,
  • Wu L,
  • Yu Z,
  • Luo X

Journal volume & issue
Vol. Volume 14
pp. 765 – 773

Abstract

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Jing Zhao, Qianqian Kong, Minghuan Wang, Hao Huang, Xirui Zhou, Yinping Guo, Yi Zhang, Lingshan Wu, Zhiyuan Yu, Xiang Luo Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Xiang Luo, Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China, Tel +86 27-83663337, Email [email protected]: Excessive daytime sleepiness (EDS) and cerebral small vessel disease (CSVD) are common problems among older adults; however, their association is not clear. The present study aimed to investigate the frequency of EDS in CSVD patients and the relationship between EDS and neuroimaging markers of CSVD.Patients and Methods: We conducted a cross-sectional study among 1076 community-dwelling older adults aged 55– 85 years. EDS was measured using the Epworth Sleepiness Scale (ESS), and EDS was defined as an ESS score greater than 10. Binary logistic regression was performed to assess the association between EDS and neuroimaging markers of CSVD.Results: Of the 1076 participants (mean age: 65.58 ± 6.46 years, 60.5% female), the prevalence of EDS was 10.0%. EDS was more frequent in participants with CSVD than in the total sample (20.0% vs 10.0%, p < 0.001). In fully adjusted models, EDS was significantly correlated with CSVD burden (OR = 1.39, 95% CI 1.16 to 1.68, p < 0.001), the severity of white matter hyperintensities (WMH) (OR = 1.33, 95% CI 1.14 to 1.54, p < 0.001), and presence of lacunes (OR = 2.47, 95% CI 1.53 to 4.00, p < 0.001) but not with the presence of cerebral microbleeds (CMBs) (OR=1.54, 95% CI 0.92 to 2.56, p = 0.099) or severity of enlarged perivascular spaces (EPVS) in basal ganglia (OR = 1.16, 95% CI 0.70 to 1.92, p = 0.564).Conclusion: We found a high frequency of EDS symptoms in CSVD individuals. Further, EDS was significantly associated with WMH, lacunes, and CSVD burden. Our findings further suggest patients with CSVD may exhibit abnormal sleep-wake patterns.Keywords: cerebral small vessel disease, daytime sleepiness, sleep disorders, white matter hyperintensities, lacunes

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