Sleep Disordered Breathing and White Matter Hyperintensities in Community-Dwelling Elders

To examine the association between markers of sleep-disordered breathing (SDB) and white matter hyperintensity (WMH) volume in an elderly, multiethnic, community-dwelling cohort. This is a cross-sectional analysis from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a community-based epidemiological study of older adults. Structural magnetic resonance imaging was obtained starting in 2004; the Medical Outcomes Study-Sleep Scale (MOS-SS) was administered to participants starting in 2007. Linear regression models were used to assess the relationship between the two MOS-SS questions that measure respiratory dysfunction during sleep and quantified WMH volume among WHICAP participants with brain imaging. A total of 483 older adults had both structural magnetic resonance imaging and sleep assessment. Self-reported SDB was associated with WMH. After adjusting for demographic and vascular risk factors, WMH volumes were larger in individuals with frequent snoring (β = 2.113, P = 0.004) and among those who reported waking short of breath or with headache (β = 1.862, P = 0.048). In community-dwelling older adults, self-reported measures of SDB are associated with larger WMH volumes. The cognitive effects of SDB that are increasingly being recognized may be mediated at the small vessel level. White matter hyperintensities are a frequent manifestation of subclinical cerebrovascular disease and are linked to dementia. Our study confirms the association between sleep-disordered breathing and white matter hyperintensities in an elderly, community-dwelling cohort. These findings significantly enhance the generalizability of this relationship and may have implications for dementia prevention and treatment.