Non breathing-related sleep fragmentation and imaging markers in patients with atherosclerotic cerebral small vessel disease (CSVD), a cross-sectional case-control study
Abstract Objective: Evidence of a relationship between non breathing-related sleep fragmentation and imaging markers of the brain in cerebral small vessel disease (CSVD) patients is scarce. The purpose of the present study was to investigate the relationship in CSVD patients living in China, where CSVD is a major pathogenesis underlying stroke. Methods: A group of 84 CSVD patients were prospectively recruited along with 24 age and sex matched normal controls. 3.0 T superconducting magnetic resonance imaging and overnight polysomnography were conducted in all the participants. Polysomnography parameters including sleep onset latency, total sleep time; sleep efficiency, wake after sleep onset, percentage of each sleep stage (N1, N2, N3 and REM) and arousal index were compared between the CSVD patients and normal controls, and the relationship between arousal index and CSVD markers was explored in the CSVD group. Results: Polysomnography measures showed that CSVD patients had significantly higher arousal index and wake after sleep onset, lower sleep efficiency and N-3 ratio compared to normal controls (p< 0.05). The results of ordinal logistic regression showed that higher arousal index was positively associated with the severity of periventricular white matter hyperintensity (OR 1.177, 95% CI 0.170 to 2.295) and perivascular space (OR 1.245, 95% CI 0.485 to 2.124) in CSVD patients, after adjusting for all the independent variables. Conclusions: These preliminary results indicate that non breathing-related sleep fragmentation is common and related to the pathological markers of CSVD patients. Future prospective research is invited to establish the causal relationship between sleep parameters and CSVD pathology.