STUDY OBJECTIVES Insomnia with objective short sleep duration has been previously associated with adverse cardiometabolic health outcomes as well as poorer cognitive performance in otherwise noncognitively impaired adults. However, studies demonstrating an increased prevalence of cognitive impairment (CI) in this insomnia phenotype are lacking. METHODS We analyzed data from Penn State Adult Cohort (N = 1,524; 48.9 ± 13.4 years; 53.4% women). Self-reported sleep difficulty was defined as normal sleep (n = 899), poor sleep (n = 453), and chronic insomnia (n = 172). Objective short sleep duration was defined as less than 6-h of sleep, based on in-lab, 8-h polysomnography. CI (n = 155) and possible vascular cognitive impairment (pVCI, n = 122) were ascertained using a comprehensive neuropsychological battery. Analyses adjusted for age, sex, race, education, body mass index, apnea/hypopnea index, smoking, alcohol, psychoactive medication, and mental and physical health problems. RESULTS Participants who reported poor sleep or chronic insomnia and slept objectively less than 6 hours were associated with a 2-fold increased odds of CI (OR = 2.06, 95% confidence limits [CL] = 1.15-3.66 and OR = 2.18, 95% CL = 1.07-4.47, respectively) and of pVCI (OR = 1.94, 95% CL = 1.01-3.75 and OR = 2.33, 95% CL = 1.07-5.06, respectively). Participants who reported poor sleep or chronic insomnia and slept objectively more than 6 hours were not associated with increased odds of either CI (OR = 0.72, 95% CL = 0.30-1.76 and OR = 0.75, 95% CL = 0.21-2.71, respectively) or pVCI (OR = 1.08, 95% CL = 0.42-2.74 and OR = 0.76, 95% CL = 0.16-3.57, respectively). CONCLUSIONS Insomnia with objective short sleep duration is associated with an increased prevalence of CI, particularly as it relates to cardiometabolic health (i.e. pVCI). These data further support that this insomnia phenotype may be a more biologically severe form of the disorder associated with cardiovascular, cerebrovascular, and neurocognitive morbidity.

中文翻译：

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客观睡眠时间短的失眠与认知障碍有关：首先看看心脏代谢对大脑健康的贡献

研究目标 之前，客观睡眠时间短的失眠与不良的心脏代谢健康结果以及其他非认知障碍成年人的认知能力较差有关。然而，缺乏研究表明这种失眠表型的认知障碍 (CI) 患病率增加。方法我们分析了宾夕法尼亚州立大学成人队列（N = 1,524；48.9 ± 13.4 岁；53.4% 女性）的数据。自我报告的睡眠困难被定义为正常睡眠 (n = 899)、睡眠不佳 (n = 453) 和慢性失眠 (n = 172)。根据实验室内 8 小时多导睡眠图，客观短睡眠持续时间定义为睡眠时间少于 6 小时。CI (n = 155) 和可能的血管认知障碍 (pVCI, n = 122) 是使用综合神经心理学电池确定的。针对年龄、性别、种族、教育、体重指数、呼吸暂停/呼吸不足指数、吸烟、饮酒、精神药物以及身心健康问题。结果 报告睡眠不佳或慢性失眠且客观睡眠时间少于 6 小时的参与者与 CI 几率增加 2 倍相关（OR = 2.06，95% 置信限 [CL] = 1.15-3.66 和 OR = 2.18，95% CL = 1.07-4.47，分别）和 pVCI（OR = 1.94，95% CL = 1.01-3.75 和 OR = 2.33，95% CL = 1.07-5.06，分别）。报告睡眠不佳或慢性失眠且客观睡眠时间超过 6 小时的参与者与任一 CI 的几率增加无关（OR = 0.72, 95% CL = 0.30-1.76 和 OR = 0.75, 95% CL = 0.21-2.71，分别) 或 pVCI（分别为 OR = 1.08, 95% CL = 0.42-2.74 和 OR = 0.76, 95% CL = 0.16-3.57）。结论 客观睡眠持续时间短的失眠与 CI 的患病率增加有关，特别是因为它与心脏代谢健康（即 pVCI）有关。这些数据进一步支持这种失眠表型可能是一种与心血管、脑血管和神经认知疾病相关的疾病在生物学上更严重的形式。