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 3 Associations between sleep complaints, hypnotics use, and incidence of Alzheimer 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 Alzheimer dementia
	n=6626		No, n = 6156		Yes, n = 470		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)								0.28		0.33		0.58
No	5457	82.36	5090	82.68	367	78.09	1		1		1
Yes	1169	17.64	1066	17.32	103	21.91	1.14 [0.90–1.43]		1.12 [0.89–1.42]		1.07 [0.85–1.35]
Difficulty with initiating sleep (DIS)								0.56		0.61		0.22
No	4304	64.96	4018	65.27	286	60.85	1		1		1
Yes	2322	35.04	2138	34.73	184	39.15	0.94 [0.77–1.15]		0.95 [0.78–1.16]		0.88 [0.72–1.08]
Difficulty in maintaining sleep (DMS)								0.19		0.16		0.07
No	2417	36.48	2247	36.50	170	36.17	1		1		1
Yes	4209	63.52	3909	63.50	300	63.83	0.88 [0.73–1.06]		0.87 [0.72–1.06]		0.84 [0.69–1.02]
Early morning awakening (EMA)								0.76		0.77		0.50
No	4201	63.40	3921	63.69	280	59.57	1		1		1
Yes	2425	36.60	2235	36.31	190	40.43	0.97 [0.80–1.18]		0.97 [0.80–1.18]		0.94 [0.77–1.14]
Sleep quality (SQ)								0.99		0.99		0.39
Good	2824	47.30	2630	47.46	194	45.22	1		1		1
Bad	3146	52.70	2911	52.54	235	54.78	1.00 [0.82–1.22]		1.00 [0.82–1.22]		0.92 [0.75–1.12]
Clinical severity sleep^e (CSS)	6.20 (± 3.23)		6.17 (± 3.22)		6.57 (± 3.34)		1.00 [0.97–1.03]	0.98	1.00 [0.97–1.03]	0.94	0.98 [0.95–1.01]	0.28
Clinical severity sleep (CSS)								0.94		0.93		0.47
[0; 4]	2021	33.85	1893	34.16	128	29.84	1		1		1
[4; 7.5]	2113	35.39	1961	35.39	152	35.43	0.96 [0.76–1.22]		0.96 [0.76–1.22]		0.91 [0.72–1.16]
> 7.5	1836	30.75	1687	30.45	149	34.73	0.97 [0.75–1.24]		0.96 [0.75–1.23]		0.85 [0.66–1.10]
Hypnotic use								0.0005		0.002		0.02
No	5165	77.95	4833	78.51	332	70.64	1		1		1
Yes	1461	22.05	1323	21.49	138	29.36	1.42 [1.17;1.74]		1.38 [1.13–1.69]		1.28 [1.04–1.58]

^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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