The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set: A Scoping Review

Jonathan Blackman; Hamish D Morrison; Katie Lloyd; Amy   Gimson; Luke Vikram  Banerjee; Sebastian F Green; Rebecca  Cousins; Sarah Rudd Rudd; Sam  Harding; E J Coulthard

doi:10.1093/sleep/zsac077

The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set: A Scoping Review

Jonathan Blackman^*, Hamish D Morrison^*, Katie Lloyd, Amy Gimson, Luke Vikram Banerjee , Sebastian F Green, Rebecca Cousins , Sarah Rudd Rudd, Sam Harding, E J Coulthard

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

Study Objectives
Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment.

Methods
This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure.

Results
Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters.

Conclusions
Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.

Original language	English
Article number	zsac077
Journal	Sleep
Volume	45
Issue number	7
Early online date	4 Apr 2022
DOIs	https://doi.org/10.1093/sleep/zsac077
Publication status	E-pub ahead of print - 4 Apr 2022

Bibliographical note

Funding Information:
Above and Beyond and BRACE charities (ABL-2019-20-01 / GA2678)

Publisher Copyright:
© 2022 Sleep Research Society. Published by Oxford University Press on behalf of the Sleep Research Society.

Research Groups and Themes

Ageing and Movement Research Group

Keywords

sleep
Alzheimer’s disease
mild cognitive impairment
MCI
AD

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10.1093/sleep/zsac077Licence: CC BY

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Blackman, J., Morrison, H. D., Lloyd, K., Gimson, A., Banerjee , L. V., Green, S. F., Cousins , R., Rudd, S. R., Harding, S., & Coulthard, E. J. (2022). The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set: A Scoping Review. Sleep, 45(7), Article zsac077. Advance online publication. https://doi.org/10.1093/sleep/zsac077

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title = "The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set: A Scoping Review",

abstract = "Study Objectives Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment. Methods This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure. Results Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6\%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6\%) were described only once in the literature (33/60 (60\%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters. Conclusions Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.",

keywords = "sleep, Alzheimer{\textquoteright}s disease, mild cognitive impairment, MCI, AD",

author = "Jonathan Blackman and Morrison, \{Hamish D\} and Katie Lloyd and Amy Gimson and Banerjee, \{Luke Vikram\} and Green, \{Sebastian F\} and Rebecca Cousins and Rudd, \{Sarah Rudd\} and Sam Harding and Coulthard, \{E J\}",

note = "Funding Information: Above and Beyond and BRACE charities (ABL-2019-20-01 / GA2678) Publisher Copyright: {\textcopyright} 2022 Sleep Research Society. Published by Oxford University Press on behalf of the Sleep Research Society.",

year = "2022",

month = apr,

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doi = "10.1093/sleep/zsac077",

language = "English",

volume = "45",

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TY - JOUR

T1 - The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set

T2 - A Scoping Review

AU - Blackman, Jonathan

AU - Morrison, Hamish D

AU - Lloyd, Katie

AU - Gimson, Amy

AU - Banerjee , Luke Vikram

AU - Green, Sebastian F

AU - Cousins , Rebecca

AU - Rudd, Sarah Rudd

AU - Harding, Sam

AU - Coulthard, E J

N1 - Funding Information: Above and Beyond and BRACE charities (ABL-2019-20-01 / GA2678) Publisher Copyright: © 2022 Sleep Research Society. Published by Oxford University Press on behalf of the Sleep Research Society.

PY - 2022/4/4

Y1 - 2022/4/4

N2 - Study Objectives Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment. Methods This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure. Results Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters. Conclusions Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.

AB - Study Objectives Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment. Methods This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure. Results Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters. Conclusions Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.

KW - sleep

KW - Alzheimer’s disease

KW - mild cognitive impairment

KW - MCI

KW - AD

U2 - 10.1093/sleep/zsac077

DO - 10.1093/sleep/zsac077

M3 - Article (Academic Journal)

C2 - 35373837

SN - 0161-8105

VL - 45

JO - Sleep

JF - Sleep

IS - 7

M1 - zsac077

ER -

The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set: A Scoping Review

Abstract

Bibliographical note

Research Groups and Themes

Keywords

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