The association between sleep spindles and cognitive function in middle-aged and older men from a community-based cohort study

Jesse L. Parker*, Sarah L. Appleton, Robert J. Adams, Yohannes Adama Melaku, Angela L. D'Rozario, Gary A. Wittert, Sean A. Martin, Peter G. Catcheside, Bastien Lechat, Alison J. Teare, Barbara Toson, Andrew Vakulin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


OBJECTIVES: Previous studies examining associations between sleep spindles and cognitive function attempted to account for obstructive sleep apnea without consideration for potential moderating effects. To elucidate associations between sleep spindles, cognitive function, and obstructive sleep apnea, this study of community-dwelling men examined cross-sectional associations between sleep spindle metrics and daytime cognitive function outcomes following adjustment for obstructive sleep apnea and potential obstructive sleep apnea moderating effects.

METHODS: Florey Adelaide Male Ageing Study participants (n = 477, 41-87 years) reporting no previous obstructive sleep apnea diagnosis underwent home-based polysomnography (2010-2011). Cognitive testing (2007-2010) included the inspection time task (processing speed), trail-making tests A (TMT-A) (visual attention) and B (trail-making test-B) (executive function), and Fuld object memory evaluation (episodic memory). Frontal spindle metrics (F4-M1) included occurrence (count), average frequency (Hz), amplitude (µV), and overall (11-16 Hz), slow (11-13 Hz), and fast (13-16 Hz) spindle density (number/minute during N2 and N3 sleep).

RESULTS: In fully adjusted linear regression models, lower N2 sleep spindle occurrence was associated with longer inspection times (milliseconds) (B = -0.43, 95% confidence interval [-0.74, -0.12], p = .006), whereas higher N3 sleep fast spindle density was associated with worse TMT-B performance (seconds) (B = 18.4, 95% confidence interval [1.62, 35.2], p = .032). Effect moderator analysis revealed that in men with severe obstructive sleep apnea (apnea-hypopnea index ≥30/hour), slower N2 sleep spindle frequency was associated with worse TMT-A performance (χ 2 = 12.5, p = .006).

CONCLUSIONS: Specific sleep spindle metrics were associated with cognitive function, and obstructive sleep apnea severity moderated these associations. These observations support the utility of sleep spindles as useful cognitive function markers in obstructive sleep apnea, which warrants further longitudinal investigation.

Original languageEnglish
Pages (from-to)774-785
Number of pages12
JournalSleep Health
Issue number5
Early online date1 Jun 2023
Publication statusPublished - Oct 2023
Externally publishedYes


  • quantitative EEG
  • microarchitecture
  • impairment
  • cohort


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