Complaints of daytime sleepiness, insomnia, hypnotic use, and risk of dementia: a prospective cohort study in the elderly

Cavaillès, Clémence; Berr, Claudine; Helmer, Catherine; Gabelle, Audrey; Jaussent, Isabelle; Dauvilliers, Yves

doi:10.1186/s13195-021-00952-y

Alzheimer's Research & Therapy

Table 2 Associations between sleep complaints, hypnotics use, and incidence of all-cause dementia over a 12-year follow-up

From: Complaints of daytime sleepiness, insomnia, hypnotic use, and risk of dementia: a prospective cohort study in the elderly

Variables	Whole sample		Incident dementia				Model 1^a		Model 2^b		Model 3^c
	n = 6851		No, n = 6156		Yes, n = 695		Model 1^a		Model 2^b		Model 3^c
	n	%	n	%	n	%	HR [95%CI]^d	p	HR [95%CI]^d	p	HR [95%CI]^d	p
Excessive daytime sleepiness (EDS)								0.002		0.007		0.04
No	5610	81.89	5090	82.68	520	74.82	1		1		1
Yes	1241	18.11	1066	17.32	175	25.18	1.33 [1.11–1.60]		1.29 [1.07–1.55]		1.21 [1.01–1.46]
Difficulty with initiating sleep (DIS)								0.99		0.99		0.30
No	4431	64.68	4018	65.27	413	59.42	1		1		1
Yes	2420	35.32	2138	34.73	282	40.58	1.00 [0.85–1.18]		1.00 [0.85–1.18]		0.92 [0.78–1.08]
Difficulty in maintaining sleep (DMS)								0.40		0.27		0.10
No	2486	36.29	2247	36.50	239	34.39	1		1		1
Yes	4365	63.71	3909	63.50	456	65.61	0.93 [0.80–1.10]		0.91 [0.78–1.07]		0.87 [0.75–1.03]
Early morning awakening (EMA)								0.95		0.87		0.47
No	4331	63.22	3921	63.69	410	58.99	1		1		1
Yes	250	36.78	2235	36.31	285	41.01	1.00 [0.85–1.17]		0.99 [0.84–1.16]		0.94 [0.80–1.11]
Sleep quality (SQ)								0.59		0.49		0.06
Good	2927	47.40	2630	47.46	297	46.85	1		1		1
Bad	3248	52.60	2911	52.54	337	53.15	0.96 [0.82–1.12]		0.95 [0.81–1.11]		0.85 [0.73–1.00]
Clinical severity sleep^e (CSS)	6.22 (±3.23)		6.17 (±3.22)		6.63 (±3.32)		1.00 [0.98–1.03]	0.77	1.00 [0.98–1.03]	0.98	0.98 [0.96–1.01]	0.16
Clinical severity sleep (CSS)								0.78		0.78		0.27
[0;4]	2071	33.54	1893	34.16	178	28.08	1		1		1
[4;7.5]	2199	35.61	1961	35.39	238	37.54	1.07 [0.88–1.30]		1.05 [0.86–1.27]		0.99 [0.81–1.20]
> 7.5	1905	30.85	1687	30.45	218	34.38	1.01 [0.82–1.25]		0.98 [0.79–1.21]		0.86 [0.69–1.06]
Hypnotic use								< 0.0001		< 0.0001		0.001
No	5313	77.55	4833	78.51	480	69.06	1		1		1
Yes	1538	22.45	1323	21.49	215	30.94	1.45 [1.24–1.72]		1.46 [1.23–1.72]		1.32 [1.11–1.57]

^aAdjusted for study center, sex, mobility, and presence of the APOE-ε4 allele, stratified for the level of education
^bAdjusted for all covariates in model 1 plus diabetes mellitus, body-mass index, and cardiovascular disease
^cAdjusted for all covariates in model 2 plus depressive status
^dEstimated using Cox proportional hazard models with delayed entry and age as the time scale
^eContinuous variables were expressed as mean (standard deviation)

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