Ramos Alberto R, Agudelo Christian, Gonzalez Kevin A, Tarraf Wassim, Daviglus Martha, Gallo Linda C, Isasi Carmen I, Kaur Sonya, Lipton Richard B, Patel Sanjay R, Redline Susan, Sostres-Alvarez Daniela, Stickel Ariana M, Testai Fernando D, Talavera Gregory A, Gonzalez Hector M, Decarli Charles S
From the Department of Neurology (A.R.R., C.A., S.K.), Miller School of Medicine, University of Miami, FL; University of California, San Diego (K.A.G., H.M.G.); Wayne State University (W.T.), Detroit, MI; Institute of Minority Health Research (M.D.), University of Illinois College of Medicine, Chicago; Department of Psychology (L.C.G., A.M.S., G.A.T.), San Diego State University, CA; Albert Einstein College of Medicine (C.I.I., R.B.L.), New York, NY; Department of Medicine (S.R.P.), University of Pittsburgh School of Medicine, PA; Brigham Women's Hospital (S.R.), Harvard School of Medicine, Boston, MA; Gillings School of Global Public Health (D.S.-A.), University of North Carolina, Chapel Hill; Department of Neurology and Rehabilitation (F.D.T.), University of Illinois College of Medicine, Chicago; and University of California, Davis (C.S.D.).
Neurology. 2025 Jan 14;104(1):e210183. doi: 10.1212/WNL.0000000000210183. Epub 2024 Dec 18.
Sleep disordered breathing (SDB) is a risk factor of stroke and Alzheimer disease and related dementias (ADRDs). Hispanic/Latino adults have higher risk of SDB and ADRDs, which emphasizes the need to better understand the association between SDB and brain health. Furthermore, results on SDB and brain aging are mixed, and there are limited data for Hispanic/Latino adults. The main goal of this study is to assess the association between SDB and brain MRI measures in a diverse Hispanic/Latino population.
The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a community-based prospective cohort multisite (Bronx, Chicago, Miami, San Diego) study of diverse Hispanic/Latino adults in the United States. Participants underwent 1 night of unsupervised home testing with a sleep apnea test device at baseline. The SOL-Investigation of Neurocognitive Aging MRI, an ancillary study, recruited 2,667 HCHS/SOL participants (35-85 years) who underwent neuroimaging approximately 10 years after baseline sleep assessment. The main exposure was the respiratory event index (REI, 3% desaturation). Secondary exposures encompassed measures of oxygen saturation. Main outcomes included total brain, gray matter, white matter hyperintensity (WMH), and hippocampal volumes. Survey linear regression models were used to determine associations between SDB and brain MRI measures.
The mean age was 67.6 years, with a body mass index of 29.7, and 58.3% were female. We found that increased REI was associated with larger hippocampal volumes ( = 0.006 [0.001-0.012]). These results were consistent with oxygen levels (minimum SpO%) during sleep ( = -0.013 [-0.021 to -0.004]). Lower oxygen levels (mean SpO) during sleep were associated with enlarged WMH volumes ( = -0.095 [-0.164 to -0.025]).
We found that SDB and worse oxygenation during sleep were linked to larger hippocampal volumes. These results underscore the complex relationships between sleep health and brain aging and warrant longitudinal follow-up, starting in middle age or earlier.
睡眠呼吸障碍（SDB）是中风、阿尔茨海默病及相关痴呆症（ADRDs）的一个风险因素。西班牙裔/拉丁裔成年人患SDB和ADRDs的风险更高，这凸显了深入了解SDB与大脑健康之间关联的必要性。此外，关于SDB与大脑老化的研究结果不一，且针对西班牙裔/拉丁裔成年人的数据有限。本研究的主要目的是评估在多样化的西班牙裔/拉丁裔人群中SDB与脑部磁共振成像（MRI）测量指标之间的关联。
西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）是一项基于社区的前瞻性队列多地点（布朗克斯、芝加哥、迈阿密、圣地亚哥）研究，研究对象为美国多样化的西班牙裔/拉丁裔成年人。参与者在基线时使用睡眠呼吸暂停测试设备进行了1晚的无监督家庭测试。作为一项辅助研究的SOL-神经认知老化MRI调查，招募了2667名HCHS/SOL参与者（35 - 85岁），他们在基线睡眠评估约10年后接受了神经影像学检查。主要暴露因素是呼吸事件指数（REI，3%血氧饱和度下降）。次要暴露因素包括血氧饱和度测量指标。主要结局包括全脑、灰质、白质高信号（WMH）和海马体体积。使用调查线性回归模型来确定SDB与脑部MRI测量指标之间的关联。
平均年龄为67.6岁，体重指数为29.7，58.3%为女性。我们发现呼吸事件指数升高与海马体体积增大有关（β = 0.006 [0.001 - 0.012]）。这些结果与睡眠期间的氧水平（最低血氧饱和度[SpO%]）一致（β = -0.013 [-0.0
