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Sleep characteristics and risk of Alzheimer’s disease: a systematic review and meta-analysis of longitudinal studies

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Abstract

Background

Alzheimer’s disease (AD) is on the rise in our aging society, making it crucial to identify additional risk factors to mitigate its increasing incidence. This systematic review and meta-analysis aimed to provide updated evidence regarding the association between sleep and AD.

Methods

We conducted a comprehensive search of MEDLINE, EMBASE, and Web of Science databases from inception to July 2023 to identify longitudinal studies. Adjusted relative risks were pooled for each sleep characteristic, and a dose–response analysis was performed specifically for sleep duration.

Results

A total of 15,278 records were initially retrieved, and after screening, 35 records were ultimately included in the final analysis. The results showed that insomnia (RR, 1.43; 95%CI, 1.17–1.74), sleep-disordered breathing (RR, 1.22; 95%CI, 1.07–1.39), as well as other sleep problems, including sleep fragmentation and sleep-related movement disorders, were associated with a higher risk of developing AD, while daytime napping or excessive daytime sleepiness (RR, 1.18; 95%CI, 1.00–1.40) only exhibited a trend toward a higher risk of AD development. Furthermore, our analysis revealed a significant association between self-reported sleep problems (RR, 1.34; 95%CI, 1.26–1.42) and the incidence of AD, whereas this association was not observed with sleep problems detected by objective measurements (RR, 1.14; 95%CI, 0.99–1.31). Moreover, both quite short sleep duration (< 4 h) and long duration (> 8 h) were identified as potential risk factors for AD.

Conclusions

Our study found the association between various types of sleep problems and an increased risk of AD development. However, these findings should be further validated through additional objective device-based assessments. Additional investigation is required to establish a definitive causal connection between sleep problems and AD.

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Data availability

All data analyzed during this study are included in supplementary materials.

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Funding

This work was supported by the Sichuan Science and Technology Program (Grant No. 2022ZDZX0023). The funders had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript; and decision to submit the manuscript.

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Author notes

  1. Shichan Wang and Xiaoting Zheng have been contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China

    Shichan Wang, Xiaoting Zheng, Jingxuan Huang, Jiyong Liu, Chunyu Li & Huifang Shang

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  1. Shichan Wang
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  2. Xiaoting Zheng
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  3. Jingxuan Huang
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Contributions

WSC, XTZ: Study selections, data collection, and manuscript drafting designed. JXH, JYL: Study selections, data collection. CYL, HFS: Study design, statistical analysis and interpretation, and revision of the manuscript.

Corresponding authors

Correspondence to Chunyu Li or Huifang Shang.

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Wang, S., Zheng, X., Huang, J. et al. Sleep characteristics and risk of Alzheimer’s disease: a systematic review and meta-analysis of longitudinal studies. J Neurol (2024). https://doi.org/10.1007/s00415-024-12380-7

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