Sleep stability, emotional memory and risk for neurodegeneration in World Trade Center Responders

项目摘要 世界贸易中心(WTC)的应答者自我报告睡眠质量较差的水平较高，并表现出较高的 睡眠障碍的流行，如阻塞性睡眠呼吸暂停(OSA)和失眠。研究 对这一人群的大脑健康调查表明，早期认知障碍和 与WTC现场两种颗粒性神经毒素物理暴露相关的神经变性 和慢性创伤后应激障碍(PTSD)。有证据表明，睡眠质量差是 与认知障碍相关的两种睡眠中神经变性和痴呆的生物标记物 精神障碍和普通社区。然而，目前还不知道睡眠质量差是否会导致 WTC应答者神经变性风险增加。睡眠质量是一个术语，包括 睡眠的启动、维持、数量和苏醒后恢复的多个方面。它是 通常使用评估当前总体满意度的调查问卷进行主观评估 睡眠相关的生活质量、睡眠行为或症状。一个潜在的有用的，客观的 衡量睡眠质量的指标是睡眠稳定性。睡眠稳定性的衡量标准可以通过 中枢神经系统(CNS)的晶状体进行脑电(EEG)或相应的 使用心肺偶联(CPC)的自主神经系统(ANS)活动。脑电快速测量 眼动(REM)和非REM(NREM)睡眠不稳定是失眠和OSA的特征。 OSA引起的睡眠不稳定导致睡眠依赖记忆受损和标志物增加 神经退行性变。与REM不稳定的表现--REM减少和延迟有关 在一个大的社区队列中患痴呆症的风险增加。高质量的脑电信号很难获得 在家但较新的可穿戴CPC测量设备可以提供睡眠质量和障碍严重程度 来自家庭的措施。CPC测量的睡眠显示出夸大的夜间变异性 失眠。高度可变的睡眠时间表预测认知疗法的成功反应 失眠行为疗法(CBTI)。我们计划招募40名WTC响应者，他们将经历2 几周的居家CPC睡眠监测，然后在实验室进行过夜的睡眠前/后PSG 情绪记忆、图片任务和采血。目标1a是测试单夜快速眼动睡眠 通过脑电活动衡量的不稳定性与情绪记忆受损有关。探险目标 1B将测试夜间记忆处理受损和夜间记忆处理受损之间的任何潜在联系 血浆生物标志物Tau和NFL的变化。目标2是测试睡眠质量是否不一致 以夜间变异性衡量的CPC与夜间较高的血浆TAU和NFL相关 级别。

Project Summary World Trade Center (WTC) Responders self-report high levels of poor sleep quality and exhibit a high prevalence of sleep disorders such as obstructive sleep apnea (OSA) and insomnia. Research investigating brain health in this population indicates early-age cognitive impairments and neurodegeneration associated with both physical exposures of particulate neurotoxins at the WTC site and chronic post-traumatic stress disorder (PTSD). There is evidence that poor sleep quality is associated with cognitive impairments, biomarkers of neurodegeneration and dementia in both sleep disorders and the general community. However, it is not known if poor sleep quality contributes to increased risk of neurodegeneration in WTC Responders. Sleep quality is a term that encompasses multiple aspects of sleep initiation, maintenance, quantity, and refreshment upon awakening. It is typically assessed subjectively using questionnaires that evaluate general satisfaction with current sleep-related quality of life, sleep behaviors or symptoms. A potentially useful, and objectively measured, proxy for sleep quality is sleep stability. Metrics of sleep stability can be obtained through the lens of the central nervous system (CNS) with electroencephalography (EEG) or the corresponding autonomic nervous system (ANS) activity using cardiopulmonary coupling (CPC). EEG-measured rapid eye movement (REM) and non-REM (NREM) sleep instability is characteristic of insomnia and OSA. Sleep instability caused by OSA results in impaired sleep-dependent memory and increases in markers of neurodegeneration. Reduced and delayed REM, manifestations of REM instability, are associated with increased risk of dementia in a large community cohort. Quality EEG signals are difficult to obtain at-home but newer, wearable CPC-measuring devices can provide sleep quality and disorder severity measures from the home. CPC measured sleep demonstrates exaggerated night-to-night variability in insomnia. Highly variable sleep schedules predict successful response to treatment with cognitive behavioral therapy for insomnia (CBTi). We plan to enroll 40 WTC Responders who will undergo 2 weeks at-home CPC sleep monitoring followed by an overnight in-lab PSG with pre/post-sleep emotional memory picture task and blood sampling. Aim 1a is to test whether single-night REM sleep instability measured by EEG activity is associated with impaired emotional memory. Exploratory Aim 1b is to test any potential association between impaired overnight memory processing and overnight change in plasma biomarkers Tau and NFL. Aim 2 is to test whether inconsistent sleep quality measured by night-to-night variability in CPC is associated with greater evening plasma Tau and NFL levels.