Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

June 1, 2021

Authors: Jessica Nicolazzo, Katharine Xu, Alexandra Lavale, Rachel Buckley, Nawaf Yassi, Garun S Hamilton, Paul Maruff, Andree-Ann Baril, Yen Ying Lim, Matthew P Pase

Journal: Sleep

DOI: 10.1093/sleep/zsab097

Year Published: 2021

Study objectives

To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample.


A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups.


Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02).


More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

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