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Background <p>Research on sleep duration and cognitive function has primarily relied on cross-sectional designs or single-time assessments, overlooking the longitudinal patterns of sleep behavior. This study aims to explore the synergistic effects of nighttime sleep and daytime napping on cognitive changes.</p> Methods <p>We identified distinct long-term sleep patterns using Dynamic Time Warping -based K-medoids clustering analysis of three sleep data sets from 4,385 participants aged 55 and older. We examined the association between these patterns and cognitive decline and AACD-defined cognitive impairment incidence via linear mixed-effects models and time-censored Cox proportional hazards regression analysis.</p> Results <p>Three sleep pattern clusters were identified: Cluster 1 (moderate-stable sleep duration, increasing napping), Cluster 2 (long-stable sleep, frequent napping), and Cluster 3 (progressively shorter sleep, infrequent napping). Compared with Cluster 1, both Cluster 2 (β = -0.11, 95% CI: -0.16 to -0.05) and Cluster 3 (β = -0.09, 95% CI: -0.13 to -0.04) exhibited significantly greater cognitive decline. In fully adjusted Cox models, Cluster 3 was modestly associated with a higher likelihood of AACD-defined cognitive impairment (HR = 1.15, 95% CI: 1.02 to 1.23), while Cluster 2 showed no significant association.</p> Conclusions <p>Distinct long-term sleep-nap patterns are differentially associated with cognitive outcomes. Shortening sleep duration over time with limited napping may be associated with a higher likelihood of AACD-defined cognitive impairment. These findings highlight the potential importance of monitoring longitudinal sleep behaviors in older adults, although further studies are needed to clarify the underlying mechanisms.</p>

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Sleep patterns and impaired cognitive function in adults aged ≥ 55 years: a longitudinal study in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月2日

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  • Wei Zhang,
  • DeQing Zeng,
  • Yuge Yan,
  • YiJing Chu,
  • Yuqi Yang,
  • Jing Guo,
  • Jie Shen,
  • Jiaoling Huang

摘要

Background

Research on sleep duration and cognitive function has primarily relied on cross-sectional designs or single-time assessments, overlooking the longitudinal patterns of sleep behavior. This study aims to explore the synergistic effects of nighttime sleep and daytime napping on cognitive changes.

Methods

We identified distinct long-term sleep patterns using Dynamic Time Warping -based K-medoids clustering analysis of three sleep data sets from 4,385 participants aged 55 and older. We examined the association between these patterns and cognitive decline and AACD-defined cognitive impairment incidence via linear mixed-effects models and time-censored Cox proportional hazards regression analysis.

Results

Three sleep pattern clusters were identified: Cluster 1 (moderate-stable sleep duration, increasing napping), Cluster 2 (long-stable sleep, frequent napping), and Cluster 3 (progressively shorter sleep, infrequent napping). Compared with Cluster 1, both Cluster 2 (β = -0.11, 95% CI: -0.16 to -0.05) and Cluster 3 (β = -0.09, 95% CI: -0.13 to -0.04) exhibited significantly greater cognitive decline. In fully adjusted Cox models, Cluster 3 was modestly associated with a higher likelihood of AACD-defined cognitive impairment (HR = 1.15, 95% CI: 1.02 to 1.23), while Cluster 2 showed no significant association.

Conclusions

Distinct long-term sleep-nap patterns are differentially associated with cognitive outcomes. Shortening sleep duration over time with limited napping may be associated with a higher likelihood of AACD-defined cognitive impairment. These findings highlight the potential importance of monitoring longitudinal sleep behaviors in older adults, although further studies are needed to clarify the underlying mechanisms.