Sleep characteristics and white matter hyperintensities among midlife women

Rebecca C. Thurston, Minjie Wu, Howard J. Aizenstein, Yuefang Chang, Emma Barinas Mitchell, Carol A. Derby, Pauline M. Maki

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Study Objectives: Sleep disturbance is common among midlife women. Poor self-reported sleep characteristics have been linked to cerebrovascular disease and dementia risk. However, little work has considered the relation of objectively assessed sleep characteristics and white matter hyperintensities (WMHs), a marker of small vessel disease in the brain. Among 122 midlife women, we tested whether women with short or disrupted sleep would have greater WMH, adjusting for cardiovascular disease (CVD) risk factors, estradiol, and physiologically assessed sleep hot flashes. Methods: We recruited 122 women (mean age = 58 years) without a history of stroke or dementia who underwent 72 h of actigraphy to quantify sleep, 24 h of physiologic monitoring to quantify hot flashes; magnetic resonance imaging to assess WMH; phlebotomy, questionnaires, and physical measures (blood pressure, height, and weight). Associations between actigraphy-assessed sleep (wake after sleep onset and total sleep time) and WMH were tested in linear regression models. Covariates included demographics, CVD risk factors (blood pressure, lipids, and diabetes), estradiol, mood, and sleep hot flashes. Results: Greater actigraphy-assessed waking after sleep onset was associated with more WMH [B(SE) = .008 (.002), p = 0.002], adjusting for demographics, CVD risk factors, and sleep hot flashes. Findings persisted adjusting for estradiol and mood. Neither total sleep time nor subjective sleep quality was related to WMH. Conclusions: Greater actigraphy-assessed waking after sleep onset but not subjective sleep was related to greater brain WMH among midlife women. Poor sleep may be associated with brain small vessel disease at midlife, which can increase the risk for brain disorders.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
Issue number6
StatePublished - Jun 1 2020


  • Actigraphy
  • Brain
  • Sleep
  • White matter hyperintensities

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)


Dive into the research topics of 'Sleep characteristics and white matter hyperintensities among midlife women'. Together they form a unique fingerprint.

Cite this