Lighter sleep and obstructive sleep apnea associate with higher enlarged perivascular spaces 15 years later
Bibliographic record
Abstract
Abstract Background Enlarged perivascular spaces (ePVS) and sleep disturbances have been associated with incident dementia. While healthy sleep is suggested to promote glymphatic clearance in the brain, poorer sleep may be associated with higher ePVS burden (representing impaired perivascular drainage), which may contribute to sleep’s role in dementia risk. We assessed the association between sleep characteristics measured with polysomnography and subsequent ePVS burden. Method Within the Framingham Heart Study, 522 participants (age: 46.1±9.0 years; 50.4%M) underwent a full‐night in‐home polysomnography. Sleep variables measuring sleep architecture (total sleep time, wake after sleep onset, sleep efficiency), sleep stages (N1, N2, N3 and REM sleep in absolute minutes and percent of total sleep time), and obstructive sleep apnea severity (apnea‐hypopnea index, obstructive sleep apnea categories [mild, moderate, severe], sleep time <90% SaO2) were extracted. On average 16.7 ± 2.6 years later, participants underwent magnetic resonance imaging. ePVS were rated in the basal ganglia and centrum semiovale, and dichotomized for analyses: low burden (<20 counts, grade 1 and 2) or high burden (>20 counts, grade 3 and 4). Logistic regressions analyses relating sleep characteristics to ePVS burden were used, adjusted for age, sex, time interval between polysomnography and magnetic resonance imaging, APOE4 allele carrier status, hypertension, and smoking. Results 21 participants had high ePVS burden in basal ganglia, and 68 participants in the centrum semiovale. Longer time spent in N1 (minutes and % of total sleep time; OR[95%]: 1.02[1.00‐1.04], p = 0.026; 1.11[1.03‐1.19], p = 0.008 respectively), shorter time spent in N3 (minutes; OR[95%]: 0.99[0.98‐0.99], p = 0.029), and longer time spent <90% SaO2 (OR[95%]: 1.03[1.00‐1.05], p = 0.025) were associated with higher ePVS burden in the centrum semiovale. No other associations between sleep characteristics and ePVS ratings were observed. Conclusion Lighter sleep, as characterized by longer N1 sleep and shorter N3 sleep, as well as the hypoxemia component of obstructive sleep apnea are associated with higher ePVS burden in subsequent brain magnetic resonance imaging. If replicated, these findings suggest a role for sleep disturbances in glymphatic clearance and cerebral small vessel disease, which may be implicated in the association between sleep and dementia risk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".