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@ARTICLE{Yiallourou:281127,
      author       = {Yiallourou, Stephanie and Baril, Andree-Ann and Wiedner,
                      Crystal and Misialek, Jeffrey R and Kline, Christopher E and
                      Harrison, Stephanie and Cannon, Ethan and Yang, Qiong and
                      Bernal, Rebecca and Bisson, Alycia and Himali, Dibya and
                      Cavuoto, Marina and Weihs, Antoine and Beiser, Alexa and
                      Gottesman, Rebecca F and Leng, Yue and Lopez, Oscar and
                      Lutsey, Pamela L and Purcell, Shaun M and Redline, Susan and
                      Seshadri, Sudha and Stone, Katie L and Yaffe, Kristine and
                      Ancoli-Israel, Sonia and Xiao, Qian and Vaou, Eleni Okeanis
                      and Himali, Jayandra J and Pase, Matthew P},
      title        = {{S}leep architecture and dementia risk in adults: an
                      analysis of 5 cohorts from the {S}leep and {D}ementia
                      {C}onsortium.},
      journal      = {Sleep},
      volume       = {48},
      number       = {9},
      issn         = {0161-8105},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {DZNE-2025-01086},
      pages        = {zsaf129},
      year         = {2025},
      abstract     = {Poor sleep may play a role in the risk of dementia.
                      However, few studies have investigated the association
                      between polysomnography (PSG)-derived sleep architecture and
                      dementia incidence. We examined the relationship between
                      sleep architecture and dementia incidence across five
                      US-based cohort studies from the Sleep and Dementia
                      Consortium.Percent of time spent in stages of sleep (N1, N2,
                      N3, rapid eye movement sleep), wake after sleep onset, sleep
                      maintenance efficiency, apnea-hypopnea index, and relative
                      delta power were derived from a single night home-based PSG.
                      Dementia was ascertained in each cohort using its
                      cohort-specific criteria. Each cohort performed Cox
                      proportional hazard regressions for each sleep exposure and
                      incident dementia, adjusting for age, sex, body mass index,
                      antidepressant use, sedative use, and APOE e4 status.
                      Results were then pooled in a random effects model.The
                      pooled sample comprised 4657 participants $(30\%$ women)
                      aged ≥ 60 years (mean age was 74 years at sleep
                      assessment). There were 998 $(21.4\%)$ dementia cases
                      (median follow-up time of 5 to 19 years). Pooled effects of
                      the five cohorts showed no association between sleep
                      architecture and incident dementia. When pooled analysis was
                      restricted to the three cohorts which had dementia case
                      ascertainment based on DSM-IV/V criteria (n = 2374), higher
                      $N3\%$ was marginally associated with an increased risk of
                      dementia (hazard ratio (HR): 1.06; $95\%CI:$ 1.00-1.12, per
                      percent increase N3, p = .050).There were no consistent
                      associations between sleep architecture measured and the
                      risk of incident dementia. Implementing more nuanced sleep
                      metrics and examination of associations with dementia
                      subtypes remains an important next step for uncovering more
                      about sleep-dementia associations.},
      keywords     = {Humans / Dementia: epidemiology / Female / Male / Aged /
                      Polysomnography / Middle Aged / Cohort Studies / Risk
                      Factors / Incidence / Sleep: physiology / Sleep Stages:
                      physiology / United States: epidemiology / Alzheimer’s
                      disease (Other) / dementia (Other) / sleep (Other) / sleep
                      macro-architecture (Other)},
      cin          = {AG Hoffmann},
      ddc          = {610},
      cid          = {I:(DE-2719)1510600},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40377976},
      pmc          = {pmc:PMC12417016},
      doi          = {10.1093/sleep/zsaf129},
      url          = {https://pub.dzne.de/record/281127},
}