Date of Award:
Master of Science (MS)
JoAnn T. Tschanz
Gail B. Rattinger
M. Scott DeBerard
Over 71 million Americans will be over the age of 65 by the year 2030. With this rise in adults aged 65 years and older also comes an exponential rise in the estimated number of individuals with Alzheimer’s disease (AD); this number is expected to exceed 24 million Americans by the year 2040. The number one risk factor for AD is older age; this factor is also associated with an increased risk in developing a sleep disturbance. Sleep disturbances have been associated with an increased risk of cancer, heart disease, and decline in overall health. Recent research has examined the association between sleep disturbance and risk for AD; however, these results are mixed. This project analyzed existing data from the population-based longitudinal Cache County Study on Memory and Aging (CCSMA), which included permanent residents of Cache County, Utah who were aged 65 years or older in 1995. The CCSMA consisted of 4-triennal waves and ran from 1995 until 2007; the aim of the original study was to examine antecedents of AD and other forms of dementia.
In this thesis, the first study examined whether sleep disturbance was associated with increased risk in developing AD. Sleep disturbance was associated with risk of developing AD, but the results differed between males and females. Among females, endorsing sleep disturbance was associated with a 54.5% decrease in the hazards of developing AD (Hazard Ratio [HR]= .455, p = .0001) compared to females without sleep disturbance. Among males, sleep disturbance was not associated with risk of developing AD (p = 0.498).
The second study evaluated if use of sleep medications was associated with increased risk of developing AD and if that association differed between males and females: males who reported use of sleep medication, regardless of having a sleep disturbance, were at increased risk of developing AD (for men without a sleep disturbance HR = 3.604; p = 0.0001). By contrast, in females, risk for developing AD varied by the presence of a sleep disturbance. Compared to the reference group (females without a sleep disturbance and no sleep medication use), females who reported a sleep disturbance and use of sleep medication were at a 35.2% reduced risk of developing AD (HR = 0.648; p = 0.011) while, those not reporting a sleep disturbance but were taking sleep medications were at 3.9 times increased risk in the hazards of developing AD (HR = 3.916; p = 0.0001). Although this study is observational in nature and therefore does not prove that the use of sleep medication is harmful, it is recommended that health care providers consider alternative, nonpharmacological approaches to treat sleep disorders in older adults. Further research is needed to examine sex differences and how they may relate to the differences associated with sleep disturbances and risk for AD.
Vernon, Elizabeth Kathleen, "Insomnia and Use of Sleep Medications in Predicting Risk of Alzheimer's Disease in the Cache County Study" (2018). All Graduate Theses and Dissertations. 7371.
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