Sex as a moderator of the sleep and cognition relationship in middle-aged and older adults: A preliminary investigation

ABSTRACT

Objectives

Despite known sex differences in the prevalence of sleep disturbance and cognitive impairment, research investigating sex differences in sleep/cognition associations is limited. We examined sex as a moderator of associations between self-reported sleep and objective cognition in middle-aged/older adults.

Methods

Adults aged 50+ (32 men/31 women, M_age = 63.6 ± 7.7) completed the Pittsburgh Sleep Quality Index (PSQI) and cognitive tasks: Stroop (processing speed, inhibition), Posner (spatial attentional orienting) and Sternberg (working memory). Multiple regressions examined whether PSQI metrics (global score, sleep quality ratings, sleep duration, sleep efficiency) were independently or interactively (with sex) associated with cognition, controlling for age and education.

Results

Sex interacted with sleep quality ratings in its association with endogenous spatial attentional orienting (∆R² = .10, p = .01). Worse ratings of sleep quality were associated with worse orienting in women (B = 22.73, SE = 9.53, p = .02), not men (p = .24). Sex interacted with sleep efficiency in its associations with processing speed (∆R² = .06, p = .04). Lower sleep efficiency was associated with slower Stroop control trial performance in women (B = −15.91, SE = 7.57, p = .04), not men (p = .48).

Conclusions

Preliminary findings suggest middle-aged/older women are more vulnerable to associations between poor sleep quality and low sleep efficiency on spatial attentional orienting and processing speed, respectively. Future studies in larger samples investigating sex-specific prospective sleep and cognition associations are warranted.

Acknowledgments

We would like to thank Jacob Wilhelm for assisting with preparation of the Institutional Review Board application. Study data, analytic methods and study materials can be made available upon request of the corresponding author. This study was not preregistered.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.