Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment--A Controlled Study.

Abstract

OBJECTIVE: Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals. METHODS: Between February 2012 and August 2014 patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD) from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Beck Depression Inventory (BDI-II). RESULTS: One hundred fifty eight consecutive patients (132 (84%) MCI patients and 26 (16%) SCD patients) and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI) patients (5.4 ± 3.5) had significantly higher PSQI scores than controls (4.3 ± 2.8, p = .003) Pairwise comparison of PSQI subscores showed that naMCI patients (1.1 ± 0.4) had significantly more "sleep disturbances" than controls (0.9 ± 0.5, p = .003). Amnestic MCI (aMCI) (0.8 ± 1.2, p = .006) and naMCI patients (0.7 ± 1.2, p = .002) used "sleep medication" significantly more often than controls (0.1 ± 0.6) Both, aMCI (11.5 ± 8.6, p < .001) and naMCI (11.5 ± 8.6, p < .001) patients showed significantly higher BDI-II scores than healthy controls (6.1 ± 5.3). Linear regression analysis showed that the subjective sleep quality was predicted by depressive symptoms in aMCI (p < .0001) and naMCI (p < .0001) patients as well as controls (p < .0001). This means, that more depressive symptoms worsened subjective sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002). DISCUSSION: Depressive symptoms were the main predictor of subjective sleep quality in MCI patients and controls, but not in SCD patients. Better global cognitive function ameliorated the negative effect of depressive symptoms on the subjective sleep quality in aMCI patients.