Sleep phenotypes and subjective cognitive decline in the Hispanic Community Health Study/Study of Latinos

Abstract Study Objectives Disturbed sleep and daytime sleepiness have been associated with subjective cognitive decline (SCD), which often precedes objective cognitive deficits and clinical dementia. Due to heterogeneity of sleep problems, researchers have used phenotype-based approaches to cluster individuals based on a group of sleep symptoms. These clusters have been associated with CPAP efficacy and cardiovascular incidence risk, but less work has related them to SCD. We sought to examine the relationships between sleep phenotypes and SCD among a diverse sample of Hispanic/Latino individuals. Methods We used data from the Hispanic Community Health Study/Study of Latinos, a large dataset of Hispanic/Latino communities. We included fifteen sleep symptoms and four cardiovascular measures in our latent class analysis model to find the optimal cluster size. SCD was assessed using the Everyday Cognition Scale. We ran survey weighted linear regression models to assess domain specific and global SCD across the groups. Results A total of N=5,551 individuals were included in the analysis. The 3-class solution was the best fit, and groups were consistent with previous work. Those in the sleepiness-disturbed sleep (N=943) or disturbed sleep (N=1,886) group had more SCD across all domains, including global, compared to those in the minimally symptomatic (N=2,722) group. Adjusting for social, cardiovascular factors, and obstructive sleep apnea attenuated but did not fully explain associations. Conclusions Daytime sleepiness and disturbed sleep clusters were associated with worse subjective cognitive decline. These findings suggest that sleep disturbances, regardless of sleep apnea, could have significant implications for cognitive health in diverse Hispanic/Latino populations. Statement of Significance Phenotype-based approaches to clustering individuals based on sleep symptomatology have been studied, but mostly in samples with high obstructive sleep apnea burden. Using a data of diverse Hispanic/Latino individuals, we demonstrated that these clusters are robust in a community-based sample. We showed that presenting insomnia or daytime sleepiness symptoms was associated with worse subjective cognitive decline compared to those with minimal sleeping problems. These findings help further our understanding of these sleep-based phenotypes and their consequences on cognitive health.