Sex Modified the Association between Sleep Duration and worse Cognitive Performance in Chinese Hypertensive Population: Insight from the China H-Type Hypertension Registry Study

Abstract

Objectives. Cognitive decline could be seen as the sign of preclinical phase of dementia, which was found to be sex differentiated. Previous studies had discovered that there might be some link between abnormal sleep duration and cognitive performance. Additionally, hypertension was found to be one of the important risk factors for cognitive decline and abnormal sleep duration was also a significant risk factor for hypertension. Therefore, the purpose of this study was to investigate sex differences in the association of sleep duration with cognitive performance and to further explore potential effect modifiers that may exist. Methods. Data analyzed in this study was from the China H-type Hypertension Registry Study. Sleep duration was assessed with a sleep questionnaire and categorized as <5 hours, 5-8 hours, and ≥8 hours. Cognitive performance was evaluated with the Mini-Mental State Examination (MMSE). Result. A total of 9527 subjects were included. The average age was $63.7\pm 9.8$ years. Linear regression analyses showed that the association between long sleep duration (≥8 h) and MMSE score adjusting for pertinent covariables was stronger in female ( $\beta =-0.95$ , 95% CI: -1.23 to -0.68, $P<0.001$ ) than in male ( $\beta =-0.29$ , 95% CI: -0.53 to -0.06, $P=0.013$ ). Furthermore, there was a significant interaction between sleep duration and age on cognitive performance only in female. Conclusion. In summary, this study found that long sleep duration (≥8 h) was associated with poorer cognitive performance. Furthermore, this association was more pronounced in female than in male, especially in older female.