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Parameters of cardiopulmonary exercise testing significantly discriminate between healthy subjects and patients with pulmonary hypertension (PH), also according to the new 2022 definition of pulmonary hypertension (mean pulmonary arterial pressure mPAP > 20 mmHg). The cut‐offs indicating on PH were peakVO2 ≤ 16.7 mL/min/kg (Youden‐Index YI = 0.79), petCO2@AT ≤ 34 mmHg (YI = 0.67), and VE/VCO2@AT ≤ 30 (YI = 0.76). [ABSTRACT FROM AUTHOR]

Summary: Poor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania‐TREND underwent laboratory‐based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino‐terminal propeptide of type 1 procollagen (P1NP) and carboxy‐terminal telopeptide of type 1 collagen (CTX) were measured. Cross‐sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea–hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound‐based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health. [ABSTRACT FROM AUTHOR]

Summary: Existing neuroimaging studies have reported divergent structural alterations in insomnia disorder (ID). In the present study, we performed a large‐scale coordinated meta‐analysis by pooling structural brain measures from 1085 subjects (mean [SD] age 50.5 [13.9] years, 50.2% female, 17.4% with insomnia) across three international Enhancing NeuroImaging Genetics through Meta‐Analysis (ENIGMA)‐Sleep cohorts. Two sites recruited patients with ID/controls: Freiburg (University of Freiburg Medical Center, Freiburg, Germany) 42/43 and KUMS (Kermanshah University of Medical Sciences, Kermanshah, Iran) 42/49, while the Study of Health in Pomerania (SHIP‐Trend, University Medicine Greifswald, Greifswald, Germany) recruited population‐based individuals with/without insomnia symptoms 75/662. The influence of insomnia on magnetic resonance imaging‐based brain morphometry using an insomnia brain score was then assessed. Within each cohort, we used an ordinary least‐squares linear regression to investigate the link between the individual regional cortical and subcortical volumes and the presence of insomnia symptoms. Then, we performed a fixed‐effects meta‐analysis across cohorts based on the first‐level results. For the insomnia brain score, weighted logistic ridge regression was performed on one sample (Freiburg), which separated patients with ID from controls to train a model based on the segmentation measurements. Afterward, the insomnia brain scores were validated using the other two samples. The model was used to predict the log‐odds of the subjects with insomnia given individual insomnia‐related brain atrophy. After adjusting for multiple comparisons, we did not detect any significant associations between insomnia symptoms and cortical or subcortical volumes, nor could we identify a global insomnia‐related brain atrophy pattern. Thus, we observed inconsistent brain morphology differences between individuals with and without insomnia across three independent cohorts. Further large‐scale cross‐sectional/longitudinal studies using both structural and functional neuroimaging are warranted to decipher the neurobiology of insomnia. [ABSTRACT FROM AUTHOR]

Summary: Obstructive sleep apnea is a common disorder that leads to sleep fragmentation and is potentially bidirectionally related to a variety of comorbidities, including an increased risk of heart failure and stroke. It is often considered a consequence of anatomical abnormalities, especially in the head and neck, but its pathophysiology is likely to be multifactorial in origin. With geometric morphometrics, and a large sample of adults from the Study for Health in Pomerania, we explore the association of craniofacial morphology to the apnea–hypopnea index used as an estimate of obstructive sleep apnea severity. We show that craniofacial size and asymmetry, an aspect of morphological variation seldom analysed in obstructive sleep apnea research, are both uncorrelated to apnea–hypopnea index. In contrast, as in previous analyses, we find evidence that brachycephaly and larger nasal proportions might be associated to obstructive sleep apnea severity. However, this correlational signal is weak and completely disappears when age‐related shape variation is statistically controlled for. Our findings suggest that previous work might need to be re‐evaluated, and urge researchers to take into account the role of confounders to avoid potentially spurious findings in association studies. [ABSTRACT FROM AUTHOR]

Google Scholar Crossref Search ADS PubMed WorldCat 53 Henke JS, Schmidt CO, Radke D, et al., SHIP Professional Input Environment (SHIPPIE), eine dynamische Webanwendung für flexible Datenerfassung in komplexen Studien. Key Features The Study of Health in Pomerania (SHIP) is a population-based project, which consists of the two independent cohorts: SHIP-START and SHIP-TREND. SHIP's partner studies so far are SHIP Pomerode in Brazil and the Polish Longitudinal University Study in Bialystok, Poland.[17] In the GANI MED consortium,[18] SHIP methods and tools are used to collect data for patient cohorts. Given the extremely comprehensive information collected from study participants and a high sampling fraction within the regional population, SHIP data are not for public use for data protection reasons.[64] Supplementary data Supplementary data are available at I IJE i online. [Extracted from the article]

Studies comparing thermodilution (TD) and the direct Fick method (dFM) for cardiac output (CO) measurement are rare. We compared CO measurements between TD (2–5 cold water injections), the dFM, and indirect Fick method (iFM) at rest and during exercise, and assessed the effect of averaging different numbers of TD measurements during exercise. This retrospective study included 300 patients (52.3% women, mean age 66 ± 11 years) having pulmonary hypertension (76.0%) or unexplained dyspnea. Invasive hemodynamic and gas exchange parameters were measured at rest (supine; n = 300) and during unloaded cycling (semi‐supine; n = 275) and 25‐W exercise (semi‐supine; n = 240). All three methods showed significant differences in CO measurement (ΔCO) at rest (p ≤ 0.001; ΔCO > 1 L/min: 45.0% [iFM vs. dFM], 42.0% [iFM vs. TD], and 45.7% [TD vs. dFM]). ΔCO (TD vs. dFM) was significant during unloaded cycling (p < 0.001; ΔCO > 1 L/min: 56.6%) but not during 25‐W exercise (p = 0.137; ΔCO > 1 L/min: 52.8%). ΔCO (TD vs. dFM) during 25‐W exercise was significant when using one or two (p ≤ 0.01) but not three (p = 0.06) TD measurements. Mean ΔCO (TD [≥3 measurements] vs. dFM) was −0.43 ± 1.98 and −0.06 ± 2.29 L/min during unloaded and 25‐W exercise, respectively. Thus, TD and dFM CO measurements are comparable during 25‐W exercise (averaging ≥3 TD measurements), but not during unloaded cycling or at rest. Individual ΔCOs vary substantially and require critical interpretation to avoid CO misclassification. [ABSTRACT FROM AUTHOR]

Background: Invasive cardiopulmonary exercise testing (iCPET) is an integral part in the advanced diagnostic workup of pulmonary hypertension (PH). Our study evaluated the relation between hemodynamic and respiratory parameters at two different resting conditions and two defined low exercise levels with a close synchronization of measurements in a broad variety of dyspnea patients. Subjects and methods: We included 146 patients (median age 69 years, range 22 to 85 years, n = 72 female) with dyspnea of uncertain origin. Invasive hemodynamic and gas exchange parameters were measured at rest, 45° upright position, unloaded cycling, 25 and 50 W exercise. All measurements were performed in a single RHC procedure. Results: Oxygen uptake (VO 2 /body mass) correlated significantly with cardiac index (all p ≤ 0.002) at every resting and exercise level and with every method of cardiac output measurement (thermodilution, method of Fick). Mean pulmonary arterial pressure (PAPmean) correlated with all respiratory parameters (respiratory rate, partial end-tidal pressures of oxygen and carbon dioxide [petCO 2 and petO 2 ], ventilation/carbon dioxide resp. oxygen ratio [VE/VCO 2 , VE/VO 2 ], and minute ventilation [VE], all p < 0.05). These correlations improved with increasing exercise levels from rest via unloaded cycling to 25 W. There was no correlation with right atrial or pulmonary arterial wedge pressure. Summary: In dyspnea patients of different etiologies, the cardiac index is closely linked to VO 2 at every level of rest and submaximal exercise. PAPmean is the only pressure that correlates with different respiratory parameters, but this correlation is highly significant and stable at rest, unloaded cycling and at 25 W. [ABSTRACT FROM AUTHOR]

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases associated with high mortality. Previous studies suggested a prognostic role for peak oxygen uptake (VO2peak) assessed during cardiopulmonary exercise testing (CPET) in patients with COPD. However, most of these studies had small sample sizes or short follow-up periods, and despite their relevance, CPET parameters are not included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) tool for assessment of severity. Objectives: We therefore aimed to assess the prognostic value of CPET parameters in a large cohort of outpatients with COPD. Methods: In this retrospective, multicentre cohort study, medical records of patients with COPD who underwent CPET during 2004–2017 were reviewed and demographics, smoking habits, GOLD grade and category, exacerbation frequency, dyspnoea score, lung function measurements, and CPET parameters were documented. Relationships with survival were evaluated using Kaplan-Meier analysis, Cox regression, and receiver operating characteristic (ROC) curves. Results: Of a total of 347 patients, 312 patients were included. Five-year and 10-year survival probability was 75% and 57%, respectively. VO2peak significantly predicted survival (hazard ratio: 0.886 [95% confidence interval: 0.830; 0.946]). The optimal VO2peak threshold for discrimination of 5-year survival was 14.6 mL/kg/min (area under ROC curve: 0.713). Five-year survival in patients with VO2peak <14.6 mL/kg/min versus ≥ 14.6 mL/kg/min was 60% versus 86% in GOLD categories A/B and 64% versus 90% in GOLD categories C/D. Conclusions: We confirm that VO2peak is a highly significant predictor of survival in COPD patients and recommend the incorporation of VO2peak into the assessment of COPD severity. [ABSTRACT FROM AUTHOR]

Background: Interstitial lung disease (ILD) is associated with high rates of comorbidities and non-infectious lung disease mortality. Against this background, we aimed to evaluate the prognostic capacity of lung function and cardiopulmonary exercise testing (CPET) in patients with ILD. Materials and Methods: A total of 183 patients with diverse ILD entities were included in this monocentric analysis. Prediction models were determined using Cox regression models with age, sex, body mass index (BMI), and all parameters from pulmonary function testing and CPET. Kaplan–Meier curves were plotted for selected variables. Results: The median follow-up period was 3.0 ± 2.5 years. Arterial hypertension (57%) and pulmonary hypertension (38%) were the leading comorbidities. The Charlson comorbidity index score was 2 ± 2 points. The 3-year and 5-year survival rates were 68% and 50%, respectively. VO2peak (mL/kg/min or %pred.) was identified as a significant prognostic parameter in patients with ILD. The cut-off value for discriminating mortality was 61%. Conclusion: The present analyses consistently revealed the high prognostic power of VO2peak %pred. and other parameters evaluating breathing efficacy (VÉ/VCO2 @AT und VÉ/VCO2 slope) in ILD patients. VO2peak %pred., in contrast to the established prognostic values FVC %pred., DLCO/KCO %pred., and GAP, showed an even higher prognostic ability in all statistical models. [ABSTRACT FROM AUTHOR]

Introduction: Sleep is increasingly recognized as a major risk factor for neurodegenerative disorders such as Alzheimer's disease (AD). Methods: Using an magnetic resonance imaging (MRI)–based AD score based on clinical data from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI1) case‐control cohort, we investigated the associations between polysomnography‐based sleep macro‐architecture and AD‐related brain atrophy patterns in 712 pre‐symptomatic, healthy subjects from the population‐based Study of Health in Pomerania. Results: We identified a robust inverse association between slow‐wave sleep and the AD marker (estimate: −0.019; 95% confidence interval: −0.03 to −0.0076; false discovery rate [FDR] = 0.0041), as well as with gray matter (GM) thicknesses in typical individual cortical AD‐signature regions. No effects were identified regarding rapid eye movement or non–rapid eye movement (NREM) stage 2 sleep, and NREM stage 1 was positively associated with GM thickness, mainly in the prefrontal cortical regions. Discussion: There is a cross‐sectional relationship between AD‐related neurodegenerative patterns and the proportion of sleep spent in slow‐wave sleep. [ABSTRACT FROM AUTHOR]

We report on a 70‐year‐old woman who tried to eliminate ants from her kitchen by applying a publicly available insecticide spray. Immediately afterwards, she felt dyspnoea, superseded by heavy chest pain. High‐sensitivity troponin concentration increased from 33 to 149 ng/L (cut‐off 50 ng/L). Significant coronary stenosis was excluded by coronary angiography, and the myocardial damage was classified as myocardial infarction type II. After exclusion of other potential mechanisms, we consider a cardiotoxic effect of the insecticide mixture of cypermethrin, tetramethrin, and piperonyl butoxide possible. We conclude that consumer information has to be improved. This concerns sustainable control measures adapted to the target insect species (in this case, the black garden ant Lasius niger), and differentiation between authorized and non‐authorized but notified products. The instructions for use should give clear information on vulnerable groups and recommend personal protective equipment. Physicians and authorities should be alert to cardiac side‐effects of insecticides. [ABSTRACT FROM AUTHOR]

Physical activity (PA) may influence cardiorespiratory fitness (CRF). Yet, PA takes place in different domains (i.e., sports‐related physical activity [SPA], leisure time related physical activity [LTPA], and work‐related physical activity [WPA]) and not all domain‐specific PA may help to maintain high CRF levels throughout life. We assessed the relationship between changes in domain‐specific PA and the age‐related decline in CRF. We analyzed data of 353 men (median age 50 years; inter‐quartile range [IQR] 40 to 60) and 335 women (median age 50 years; IQR 41 to 59) with data for domain‐specific PA as well as CRF testing measured ten years apart. CRF was assessed with cardiorespiratory exercise testing. Domain‐specific PA was measured using the Baecke questionnaire. During the 10‐year follow‐up, CRF decreased in men from 29.3 (IQR 25.0 to 34.7) mL/min/kg to 24.3 (IQR 20.8 to 27.3) mL/min/kg. In women, CRF declined from 26.0 (IQR 21.0 to 30.9) to 21.4 (IQR 18.3 to 25.6) mL/min/kg. A one point higher SPA at baseline was related to a 1.14 (95% confidence interval [CI] −1.50 to −0.53) mL/min/kg greater decrease in VO2peak. A one point greater SPA and LTPA over time was associated with a 1.68 (95% CI 1.06 to 2.29) mL/min/kg and 1.24 (95% CI 0.57 to 1.90) mL/min/kg lower decrease in VO2peak, respectively. Neither baseline values nor changes of WPA were associated with CRF. Sports and leisure time related PA may attenuate the age‐related decline in CRF. [ABSTRACT FROM AUTHOR]

Background: Forced expiratory volume in one second (FEV1) characterizes the pathophysiology of COPD and different trajectories of FEV1 decline have been observed in patients with COPD (e.g. gradual or episodic). There is limited information about the development of patient-reported health-related quality of life (HRQL) over the full range of the natural history of COPD. We examined the longitudinal association between change in FEV1 and change in disease-specific and generic HRQL.Methods: We analysed data of 1734 patients with COPD participating in the COSYCONET cohort with up to 3 years of follow-up. Patients completed the Saint George's Respiratory Questionnaire (SGRQ) and the EQ-5D Visual Analog Scale (EQ VAS). Change score models were used to investigate the relationship between HRQL and FEV1 and to calculate mean changes in HRQL per FEV1 change categories [decrease (≤ - 100 ml), no change, increase (≥ 100 ml)] after 3 years. Applying hierarchical linear models (HLM), we estimated the cross-sectional between-subject difference and the longitudinal within-subject change of HRQL as related to a FEV1 difference or change.Results: We observed a statistically significant deterioration in SGRQ (total score + 1.3 units) after 3 years, which was completely driven by the activity component (+ 4 units). No significant change was found for the generic EQ VAS. Over the same period, 58% of patients experienced a decrease in FEV1, 28% were recorded as no change in FEV1, and 13% experienced an increase. The relationship between HRQL and FEV1 was found to be approximately linear with decrease in FEV1 being statistically significantly associated with a deterioration in SGRQ (+ 3.20 units). Increase in FEV1 was associated with improvements in SGRQ (- 3.81 units). The associations between change in FEV1 and the EQ VAS were similar. Results of the HLMs were consistent and highly statistically significant, indicating cross-sectional and longitudinal associations. The largest estimates were found for the association between FEV1 and the SGRQ activity domain.Conclusions: Difference and change in FEV1 over time correlate with difference and change in disease-specific and generic HRQL. We conclude, that deterioration of HRQL should induce timely re-examination of physical status and lung function and possibly reassessment of therapeutic regimes.Trial Registration: NCT01245933. Date of registration: 18 November 2010. [ABSTRACT FROM AUTHOR]

Background: An impairment of CO diffusing capacity has been shown in diabetic patients without lung disease. We analyzed how diffusing capacity in patients with COPD is affected by the concurrent diagnosis of diabetes.Methods: Data from the initial visit of the German COPD cohort COSYCONET were used for analysis. 2575 patients with complete lung function data were included, among them 358 defined as diabetics with a reported physician diagnosis of diabetes and/or specific medication. Pairwise comparisons between groups and multivariate regression models were used to identify variables predicting the CO transfer factor (TLCO%pred) and the transfer coefficient (KCO%pred).Results: COPD patients with diabetes differed from those without diabetes regarding lung function, anthropometric, clinical and laboratory parameters. Moreover, gender was an important covariate. After correction for lung function, gender and body mass index (BMI), TLCO%pred did not significantly differ between patients with and without diabetes. The results for the transfer coefficient KCO were similar, demonstrating an important role of the confounding factors RV%pred, TLC%pred, ITGV%pred, FEV1%pred, FEV1/FVC, age, packyears, creatinine and BMI. There was not even a tendency towards lower values in diabetes.Conclusion: The analysis of data from a COPD cohort showed no significant differences of CO transport parameters between COPD patients with and without diabetes, if BMI, gender and the reduction in lung volumes were taken into account. This result is in contrast to observations in lung-healthy subjects with diabetes and raises the question which factors, among them potential anti-inflammatory effects of anti-diabetes medication are responsible for this finding. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus Type 1 (T1DM) is associated with metabolic and microvascular diseases as part of a multi-organ and multi-systemic disorder. The dense network of capillary vessels in the lungs may change during the course of the development of microangiopathy. The connective tissue as well as alveoli may be subjected to non-enzymatic glycosylation of proteins which may in turn affect pulmonary function. Previous studies investigating lung function in patients with type 1 diabetes have only been performed on small numbers of patients. Our study is based on population data of the Study of Health in Pomerania (SHIP). Objective: To investigate the influence of metabolic control on pulmonary system function and to establish a decreased pulmonary system function as a late complication of T1DM in a population based setting. Methods: The study is a case matched study with multiple controls based on participants with T1DM (SHIP-DM-1, n = 73) and non-diabetics (SHIP-1, n = 292) from the population based study of Pomerania. Data on lung function and exercise performance stratified by age, sex, body mass index and smoking habits in participants with T1DM and without diabetes were matched. Results: Participants with T1DM showed a significantly lower total lung capacity, residual volume and forced vital capacity. The transfer factor for carbon monoxide, the maximum power output and oxygen uptake during exercise were significantly decreased in comparison to the general population without diabetes. Conclusion: The pattern of abnormal pulmonary function as observed in the present study with a reduction in lung volume parameters and reduced oxygen uptake in participants with T1DM suggests a restrictive type of lung disease caused by an intrinsic lung tissue derangement as well as pulmonary microangiopathy. [ABSTRACT FROM AUTHOR]

Background: Irisin, a recently discovered myokine, is assumed to be secreted by muscle cells in response to exercise and is involved in the regulation of energy metabolism by browning white adipose tissue cells. However, due to the fact that previous studies revealed conflicting results concerning the association between irisin and exercise, the aim of the present study was to investigate the potential relationship between irisin and exercise capacity in a population-based setting. Methods: From the population-based Study of Health in Pomerania (SHIP-TREND) 334 men and 406 women with irisin measurements were selected and a standardised symptom limited cardiopulmonary exercise test was used. Exercise capacity was quantified by oxygen uptake at anaerobic threshold (VO2@AT), peak exercise (peakVO2) and maximum power output at peak exertion. In addition, the oxygen pulse was assessed. ANOVA and multivariable linear regression analyses were performed stratified by sex and adjusted for age, weight, height and smoking. Results: In men, we observed inverse associations between irisin serum concentration and exercise capacity assessed by peakVO2 and maximum power output. In contrast, in women a trend towards a positive relationship between irisin and peakVO2 was detected, whereas none of the other parameters showed significant associations with irisin. Conclusion: Based on a large population sample, our results did not confirm the previous reported positive linkage between exercise and irisin. Thus the relationship needs further investigation in particular with respect to sex differences. [ABSTRACT FROM AUTHOR]

Background: Poor pulmonary health is increasingly recognized as an important risk factor for accelerated brain ageing and the development of dementia. We report on associations of spirometry with MRI‐based volumetry of the brain in the large community‐based Study of Health in Pomerania Trend (SHIP‐Trend). Method: N=1651 participants of SHIP‐Trend underwent both spirometry and MRI scans of the head. Measurements of forced expiratory volume during first second (FEV1), forced vital capacity (FVC) and relative FEV1 were standardized with respect to age, sex, and body height using the GLI 2012 reference equations. T1‐weighted MRI scans were processed with FreeSurfer 5.3 and total brain volumes (TBV), total gray matter volumes (TGM), total hippocampal volumes (HV) were determined. In addition, we considered the total volume of white matter hyperintensities (WMHV) estimated from T2‐FLAIR images and a recently proposed MRI‐based Alzheimer's disease index (FSAD). Linear regressions of MRI parameters on standardized FEV1, FVC, and relative FEV1, respectively, were performed. Age, sex, intracranial volume, height, smoking status, and presence of diabetes were added as covariates to each model. Effect sizes were assessed by Cohen's f2. Analyses were performed using data from young‐aged (≤ 60y), old‐aged (>60y), and all participants, respectively. Result: FEV1, FVC, and relative FEV1 were significantly positively associated with greater TBV, TGM, and HV in the whole sample. WMHV was significantly negatively associated with FVC and positively associated with relative FEV1. The FSAD index was significantly negatively associated with FEV1, and FVC. Associations with FEV1 and FVC were consistently stronger in old‐aged compared to young‐aged participants. For TBV, HV, WMHV, and FSAD, effect sizes were f2≈0.01. For TGM, effect sizes were f2≈0.05, significantly larger than those of diabetes. No significant associations with relative FEV1 were found in the group of old‐aged participants. Conclusion: Our results suggest that impaired lung function is a risk factor for atrophy of brain tissue. In old‐aged individuals, this seems to be specifically related to restrictive spirometry patterns (i.e. reductions in FEV1 and FVC but not relative FEV1) but not obstructive ones (i.e. reductions in relative FEV1). This work was supported by the Cognitively Healthy Nonagenarians in the Cross‐Cohort Collaboration Consortium (CCC) grant AG059421. [ABSTRACT FROM AUTHOR]

Background: Sleep is increasingly recognised as a major risk‐factor for cognitive ageing and neurodegenerative disorders such as late‐onset Alzheimer's Disease (LOAD). Poor sleep quality has been linked to impaired cerebral clearance of amyloid‐beta, neurofibrillary tangles and reduced cognitive function. Recent studies have also highlighted a relationship between disturbed sleep and age‐related changes in brain structure. Method: We used ordinary least‐squared regression adjusted for age, gender, BMI, intracranial volume and APOE4‐status to investigate the associations of MRI‐based markers of brain ageing and LOAD‐related brain atrophy patterns (Frenzel et al. 2019; Janowitz et al. 2016 and Weihs et al. 2020) as well as cognitive performance in terms of the immediate and delayed wordlist recollection from the Nuremberg‐Age‐Inventory (NAI) with questionnaire and polysomnography (PSG) based measures of sleep quality in 717 subjects from the large‐scale population‐based Study of Health in Pomerania (SHIP‐Trend). We analysed the percentage of total sleep time (TST) spent in slow‐wave and rapid eye movement (REM) sleep, sleep duration, sleep efficiency and sleep latency as objective sleep quality measures and the Pittsburgh sleep quality index (PSQI) as subjective sleep quality measure. Result: We have identified inverse associations of the percentage of TST spent in slow‐wave and REM sleep with brain atrophy related to ageing and LOAD, which was mainly driven by slow‐wave sleep, with both percentages of TST and duration showing significant inverse associations. Furthermore, there was a non‐linear u‐shaped association between sleep duration and age‐related atrophy patterns. Similar associations were found for the NAI sum score and the NAI delayed recollection sub‐score, but neither were significant after correcting for multiple testing. No associations with the PSQI score were found. Conclusion: We identified associations between PSG based sleep quality markers, but not subjective sleep quality, and brain atrophy related to ageing and LOAD. With no treatment being yet available, improving objective sleep quality, especially slow‐wave sleep, could prove a viable target to slow‐down the process of cognitive decline and reduce the risk of neurodegenerative disorders such as LOAD. [ABSTRACT FROM AUTHOR]

Identification of obstructive sleep apnea and risk factors is important for reduction in symptoms and cardiovascular risk, and for improvement of quality of life. The population‐based Study of Health in Pomerania investigated risk factors and clinical diseases in a general population of northeast Germany. Additional polysomnography was applied to measure sleep and respiration with the objective of assessing prevalence and risk factors of obstructive sleep apnea in a German cohort. One‐thousand, two‐hundred and eight people between 20 and 81 years old (54% men, median age 54 years) underwent overnight polysomnography. The estimated obstructive sleep apnea prevalence was 46% (59% men, 33% women) for an apnea–hypopnea index ≥5%, and 21% (30% men, 13% women) for an apnea–hypopnea index ≥ 15. The estimated obstructive sleep apnea syndrome prevalence (apnea–hypopnea index ≥5; Epworth Sleepiness Scale >10) was 6%. The prevalence of obstructive sleep apnea continuously increased with age for men and women with, however, later onset for women. Gender, age, body mass index, waist‐to‐hip ratio, snoring, alcohol consumption (for women only) and self‐reported cardiovascular diseases were significantly positively associated with obstructive sleep apnea, whereas daytime sleepiness was not. Diabetes, hypertension and metabolic syndrome were positively associated with severe obstructive sleep apnea. The associations became non‐significant after adjustment for body mass. Women exhibited stronger associations than men. The prevalence of obstructive sleep apnea was high, with almost half the population presenting some kind of obstructive sleep apnea. The continuous increase of obstructive sleep apnea with age challenges the current theory that mortality due to obstructive sleep apnea and cardiovascular co‐morbidities affect obstructive sleep apnea prevalence at an advanced age. Also, gender differences regarding obstructive sleep apnea and associations are significant for recognizing obstructive sleep apnea mechanisms and therapy responsiveness. [ABSTRACT FROM AUTHOR]