Impaired Recovery Sleep in Individuals with Alzheimer’s Disease – The RESTED Study
Bibliographic record
Abstract
BACKGROUND: Homeostatic sleep regulation is theorized to be governed by the 'Two Process Model' where circadian rhythm (process C) and homeostatic sleep pressure (process S) interact to determine sleep versus wakefulness. Sleep pressure accumulated during prolonged wakefulness increases the duration and intensity of subsequent 'recovery' sleep. Multiple sleep abnormalities are associated with Alzheimer's Disease (AD) Dementia and Lewy Body Dementia (LBD). This study seeks to determine whether recovery sleep duration may also be compromised. METHOD: RESTED (Remote Evaluation of Sleep To enhance understanding in Early Dementia) was an observational cohort study with three subgroups: AD MCI/dementia, LBD MCI/dementia, and healthy controls (HC). Participants wore a wrist actigraph for 55 nights continuously and provided daily sleep diaries. Recovery sleep was assessed using a random intercept lagged panel model with a dependent variable of total sleep time (TST). Prespecified covariates included age, sex, Geriatric Depression Score, Generalised Anxiety Disorder 7-Score and participant subgroup (AD/LBD/HC). Compensatory sleep represented a 'within-person' carry-over effect modelled with an autoregressive parameter (alpha). A negative value implies low TST nights are typically followed by higher TST nights, indicating compensatory or recovery sleep Interaction terms determined if alpha was affected by participant group or age. RESULT: 40 participants (AD = 10, LBD = 10, HC = 20) underwent full study procedures. Mean (SD) age was 70.9 (5.9) [AD = 69.2(7.9), LBD = 73.9(2.8), HC = 70.2(5.7)]. 9/40 (22.5%) participants were female (AD = 2/10, LB = 2/10, HC = 5/20). Mean (SD) Montreal Cognitive Assessment Score was 24.8 (4) [AD = 23.0(5), LBD = 21.9(4), HC = 27.1(1)]. Age (β = -0.11, SE = 0.05, p = 0.036), diagnosis of AD (β = -1.75, SE = 0.57, p = 0.004) and alpha (β = -0.94, SE = 0.31, p = 0.002) were all negatively associated with sleep duration. There were significant positive interactions between alpha and diagnosis of AD (β = 0.13, SE = 0.06, p = 0.026) and alpha and increasing age (β = 0.01, SE = 0.004, p = 0.001). No statistically significant effects were found linking LBD to sleep duration. CONCLUSION: Low TST nights were typically followed by higher TST nights suggesting that compensatory mechanisms were present. However, this relationship was attenuated both by the presence of AD and increasing age (approximately 10% per decade). Further research is needed to confirm these findings in larger cohorts and determine underlying pathophysiological mechanisms by which sleep recovery is compromised.
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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 | 0.001 | 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 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".