Brain and Mind Centre, The University of Sydney, 94-100 Mallett St, Camperdown, NSW 2050, Australia.
Brain and Mind Centre, The University of Sydney, 94-100 Mallett St, Camperdown, NSW 2050, Australia; Charles Perkins Centre, D17 Johns Hopkins Drive, The University of Sydney, Camperdown, NSW 2050, Australia.
Sleep Health. 2017 Jun;3(3):178-183. doi: 10.1016/j.sleh.2017.03.007. Epub 2017 Apr 10.
To examine whether poor objective and subjective sleep quality are differentially associated with cognitive function.
Cross-sectional.
Participants were recruited from primary and secondary care, and directly from the community, in Sydney, Australia.
The sample consisted of 74 men 50years and older (mean [SD], 58.4 [6.2] years), with comorbid depression and above-threshold insomnia symptoms, participating in a trial of online cognitive behavioral therapy for insomnia.
Insomnia severity and depression severity were assessed via self-report. Objective sleep efficiency and duration were measured using actigraphy. Objective cognitive function was measured using 3 subtests of a computerized neuropsychological battery.
Poor objective sleep efficiency was associated with slower reaction time (r=-0.249, P=.033) and poorer executive functioning (odds ratio, 4.14; 95% confidence interval, 1.35-12.69), but not memory. These associations remained after adjusting for age, education, depression severity, cardiovascular risk, and medication. Subjective sleep quality was not related to cognitive function.
Among older men with depression and insomnia, objectively measured poor sleep efficiency may be associated with worse cognitive function, independent of depression severity. Objective poor sleep may be underpinned by neurobiological correlates distinct from those underlying subjective poor sleep and depression, and represent a potentially effective modifiable mechanism in interventions to improve cognitive functioning in this population. This supports the use of objective measures of sleep in diagnostic assessments and care.
考察客观和主观睡眠质量差与认知功能的相关性是否不同。
横断面研究。
参与者在澳大利亚悉尼的初级和二级保健机构以及社区中招募。
该样本包括 74 名年龄在 50 岁及以上（平均[标准差]，58.4[6.2]岁）、患有共病性抑郁症和阈上失眠症状的男性，他们参加了一项在线认知行为疗法治疗失眠的试验。
通过自我报告评估失眠严重程度和抑郁严重程度。使用活动记录仪测量客观睡眠效率和持续时间。使用计算机化神经心理学测试的 3 个子测试测量客观认知功能。
客观睡眠效率差与反应时间较慢（r=-0.249，P=.033）和执行功能较差相关（优势比，4.14；95%置信区间，1.35-12.69），但与记忆无关。在调整年龄、教育程度、抑郁严重程度、心血管风险和药物治疗后，这些相关性仍然存在。主观睡眠质量与认知功能无关。
在患有抑郁症和失眠的老年男性中，客观测量的睡眠效率差可能与认知功能更差相关，而与抑郁严重程度无关。客观睡眠差可能与那些与主观睡眠差和抑郁不同的神经生物学相关，并且代表了改善该人群认知功能的干预措施中一种潜在的有效可改变的机制。这支持在诊断评估和治疗中使用客观的睡眠测量。
