• Pamela L Lutsey, Jeffrey R Misialek, Thomas H Mosley, Rebecca F Gottesman, Naresh M Punjabi, Eyal Shahar, Richard MacLehose, Rachel P Ogilvie, David Knopman, and Alvaro Alonso.
• Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. Electronic address: lutsey@umn.edu.
• Alzheimers Dement. 2018 Feb 1; 14 (2): 157-166.

IntroductionThis study tested the hypotheses that late-midlife obstructive sleep apnea (OSA) and short and long sleep duration are associated with dementia over 15 years of follow-up.MethodsA total of 1667 Atherosclerosis Risk in Communities Study participants underwent in-home polysomnography (1996-1998) and were followed for dementia. Dementia was defined by (1) hospitalization diagnosis codes (1996-2012) and (2) a comprehensive neurocognitive examination (2011-2013) with adjudication.ResultsOSA and sleep duration were not associated with risk of incident dementia. When using adjudicated outcomes, severe OSA (≥30 vs. <5 apnea-hypopnea events/hour) was associated with higher risk of all-cause dementia (risk ratio [95% confidence interval], 2.35 [1.06-5.18]) and Alzheimer's disease dementia (1.66 [1.03-2.68]); associations were attenuated with cardiovascular risk factor adjustment. Sleeping <7 versus 8 to ≤9 hours was associated with higher risk of all-cause dementia (2.00 [1.03-3.86]).DiscussionWhen adjudicated outcome definitions were used, late-midlife OSA and short sleep duration were associated with all-cause and Alzheimer's disease dementia in later life.Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

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