Abstract Introduction Sleep has emerged as a key cardiovascular health metric, with short or fragmented sleep linked to an increased risk of adverse cardiovascular outcomes in adults (1). In adolescents, poor sleep health has been associated with obesity (2) and subclinical cardiac structural alterations (3). Although some studies suggest that short sleep is related to smaller grey matter volumes in adolescents, most rely on self-reported sleep measures (4–6). Therefore, objective studies exploring the heart–brain connection in relation to sleep habits during youth are needed. Purpose To assess the association of objectively measured sleep duration and sleep quality with subclinical brain structural and perfusion changes, as assessed by advanced magnetic resonance imaging (MRI), in adolescents. Methods This cross-sectional study included healthy adolescents from the Early Imaging Markers of Unhealthy Lifestyles in Adolescents (EnIGMA) study. Sleep duration and quality (wake after sleep onset WASO and sleep fragmentation index) were assessed using a wrist-worn ActiGraph wGT3X-BT accelerometers for seven consecutive days. Brain MRI was performed on a 3T Ingenia Elition X scanner. Total brain volume (TBV), grey matter volume (GMV) and white matter volume (WMV) were derived from 3D T1-weighted images processed with FreeSurfer v6.0.1 and indexed to intracranial volume. Cerebral blood flow (CBF), grey matter perfusion (GMP), and white matter perfusion (WMP) were quantified using a time-encoded pseudo-continuous arterial spin labeling (te-ASL) sequence processed whit FSL 6.0.5.1 software. Multivariable linear regression models were used to evaluate adjusted associations between sleep parameters and MRI-derived brain volumes and perfusion measures. In addition, voxel-wise analyses of CBF were performed using SPM25 to identify brain regions most sensitive to poor sleep habits. Results A total of 92 adolescents (mean age 16.0 ± 0.5 years, 54.4% girls) were included; 84 had both volumetry and perfusion data, 7 had volumetry only, and 1 had perfusion only. Girls exhibited longer sleep duration and a trend toward better sleep quality compared with boys, along with higher indexed brain volumes and higher CBF, GMP, and WMP (Figure 1). Longer sleep duration was positively associated with greater TBV, GMV, and WMV (Figure 2A). Better sleep quality (lower WASO and fragmentation) was associated with higher GMP. Voxel-wise analysis identified localized regions where poorer sleep habits were significantly associated with reduced perfusion after adjustment for age and sex (Figure 2B and 2C). Conclusion Objectively measured sleep health is associated with subclinical alterations in brain structure and perfusion in otherwise healthy adolescents. These findings align with emerging evidence and reinforce the importance of promoting healthy sleep habits early in life to support optimal brain and cardiovascular health.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Cocera et al. (Mon,) studied this question.