Sleep Quality and Cognitive Abilities in the Greek Cohort of Epirus Health Study

Myrto Koutsonida,1 Maria Psyhogiou,2 Eleni Aretouli,3,* Konstantinos K Tsilidis1,4,* 1Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece; 2Interdisciplinary Department 10B, General Hospital “Evaggelismos”, Athens, Greece; 3Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece; 4Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK*These authors contributed equally to this workCorrespondence: Eleni Aretouli; Konstantinos K Tsilidis, Tel +30 2651005775 ; +44 20 7594 2623, Email earetouli@uoi.gr; k.tsilidis@imperial.ac.ukPurpose: Sleep is essential to all human body functions as well as brain functions. Inadequate sleep quantity and poor sleep quality have been shown to directly affect cognitive functioning and especially memory. The primary aim of the present study was to investigate the association of sleep quality with cognitive abilities cross-sectionally in a middle-aged Greek population and secondarily to examine this association prospectively in a smaller group of these participants.Patients and Methods: A total of 2112 healthy adults aged 25– 70 years (mean: 46.7± 11.5) from the Epirus Health Study cohort were included in the analysis and 312 of them participated in secondary prospective analysis. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) scale and cognition was assessed in primary cross-sectional analyses with three neuropsychological tests, namely the Verbal Fluency test, the Logical Memory test and the Trail Making test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, the Corsi block-tapping task and the Stroop task. Statistical analysis was performed using multivariable linear regression models adjusted for age, sex, education, body mass index and alcohol consumption.Results: Attention/processing speed was the only cognitive domain associated cross-sectionally with PSQI score. Specifically, participants with better self-reported sleep quality performed faster on the Trail Making Test - Part A (β= 0.272 seconds, 95% CI 0.052, 0.493).Conclusion: Further studies are needed to clarify the association of sleep quality with cognition, especially in middle-aged people that are still in productive working years.Keywords: sleep quality, cognition, attention, executive functions, memory, middle-aged