Effects of long-term sleep disruption on cognitive function and brain amyloid-β burden: a case-control study

Jana Thomas (Corresponding author), Sharon J. Ooms, Lara J. Mentink, Jan Booij, Marcel G.M. Olde Rikkert, Sebastiaan Overeem, Roy P.C. Kessels, Jurgen A.H.R. Claassen (Corresponding author)

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BACKGROUND: Recent evidence indicates that disrupted sleep could contribute to the development of Alzheimer's disease by influencing the production and/or clearance of the amyloid-β protein. We set up a case-control study to investigate the association between long-term work-induced sleep disruption, cognitive function, and brain amyloid-β burden.

METHODS: Nineteen male maritime pilots (aged 48-60 years) with chronic work-related sleep disruption and a sex-, age-, and education-matched control sample (n = 16, aged 50-60 years) with normal sleep completed the study. Primary sleep disorders were ruled out with in-lab polysomnography. Additional sleep measurements were obtained at home using actigraphy, sleep-wake logs, and a single-lead EEG device. Cognitive function was assessed with a neuropsychological test battery, sensitive to early symptomatic Alzheimer's disease. Brain amyloid-β burden was assessed in maritime pilots using 18F-flutemetamol amyloid PET-CT.

RESULTS: Maritime pilots reported significantly worse sleep quality (Pittsburgh Sleep Quality Index (PSQI) = 8.8 ± 2.9) during work weeks, compared to controls (PSQI = 3.2 ± 1.4; 95% CI 0.01 to 2.57; p = 0.049). This was confirmed with actigraphy-based sleep efficiency (86% ± 3.8 vs. 89.3% ± 4.3; 95% CI 0.43 to 6.03; p = 0.03). Home-EEG recordings showed less total sleep time (TST) and deep sleep time (DST) during work weeks compared to rest weeks (TST 318.56 (250.21-352.93) vs. TST 406.17 (340-425.98); p = 0.001; DST 36.75 (32.30-58.58) vs. DST 51.34 (48.37-69.30); p = 0.005)). There were no differences in any of the cognitive domains between the groups. For brain amyloid-β levels, mean global cortical standard uptake value ratios of 18F-flutemetamol were all in the normal range (1.009 ± 0.059; 95% CI 0.980 to 1.037), confirmed by visual reads.

CONCLUSIONS: Capitalizing on the particular work-rest schedule of maritime pilots, this study with a small sample size observed that long-term intermittent sleep disruption had no effects on global brain amyloid-β levels or cognitive function.

Original languageEnglish
Article number101
Number of pages12
JournalAlzheimer's Research & Therapy
Issue number1
Publication statusPublished - 26 Aug 2020


This work was supported by ISAO (Internationale Stichting Alzheimer Onderzoek (now Alzheimer Nederland), grant number: 15040) awarded to JC. Philips kindly provided the home-EEG devices that were used in this study. The funders had no role in the study design or conduct; collection, analysis, or interpretation of data; nor in the writing of the report or in the decision to submit the manuscript for publication.

FundersFunder number
Internationale Stichting Alzheimer Onderzoek15040


    • Alzheimer’s disease
    • Amyloid-β
    • Cognitive function
    • Shift work
    • Sleep disruption
    • Humans
    • Alzheimer Disease/epidemiology
    • Male
    • Cognition
    • Positron-Emission Tomography
    • Case-Control Studies
    • Positron Emission Tomography Computed Tomography
    • Brain/diagnostic imaging
    • Sleep
    • Amyloid beta-Peptides/metabolism


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