0702 Prolonged Sleep Duration Predicts Poorer Cognitive Function in Hospitalized Older Adult Survivors of Critical Illness

Abstract

Introduction The aim of this study was to explore the relationship between sleep duration and cognitive function among previously mechanically ventilated older adults recently transferred out of an intensive care unit (ICU). Methods We enrolled 30 subjects, ages 65 and older, who were functionally independent prior to admission, required mechanical ventilation, and transferred out of ICU within the last 24-48 hours. Actigraphy monitored nighttime sleep continuously between 9:00PM to 9:00AM over two nights. Using the Actiwatch Spectrum, we analyzed mean total sleep time (TST). Using selected measures from the National Institutes of Health Toolbox Cognition Battery [Flanker Inhibitory Control and Attention Test (FICAT; a measure of attention)] and the Dimensional Change Card Sort Test (DCCST; a measure of cognitive flexibility)], we analyzed cognitive function and its relationship to post-ICU sleep duration. Results Subjects’ mean TST was 7.55 ± 2.52 hours, FICAT fully-corrected T-score was 29.65 ± 7.33, and DCCST fully-corrected T-score was 38.81 ± 9.20. In regression analyses, TST was significantly and negatively associated with attention (β = -0.505, p = .043). This relationship persisted after adjusting for potential confounding factors, including sex, history of obstructive sleep apnea (OSA), self-reported sleep quality, sleep medication administration, severity of illness, surgical admission, ICU readmission, and length of hospital stay. Longer sleep duration predicted poorer performance on attention. TST was also significantly and negatively associated with cognitive flexibility (β = -0.437, p = .028). This relationship persisted after adjusting for age, sex, history of OSA, self-reported sleep quality, sleep medication administration, pain medication administration, severity of illness, and length of hospital stay. Longer sleep duration predicted poorer performance on cognitive flexibility. Conclusion This cohort of hospitalized older adult ICU survivors experienced prolonged sleep, which independently predicted poor cognitive function after adjustment for relevant covariates. Future research should explore associations between prolonged sleep and actigraphy-observed inactivity periods with post-ICU cognitive outcomes among older adult ICU survivors. Support (If Any) N/A