Alterations in the global brain network in older adults with poor sleep quality: A resting-state fMRI study

Abstract

Objectives: Older adults often experience more fragmented and less restful sleep than younger individuals. However, the mechanisms in the brain that underlie these phenomena have been rarely studied. The aim of this study was to identify the differences in global brain network properties between older adults with good and poor sleep quality and to explore the relationship between these network properties and symptoms of insomnia. Methods: We performed a graph-theoretic analysis of resting-state functional magnetic resonance imaging data from two groups of older adults: 59 with good sleep quality and 59 with poor sleep quality. Functional connectivity among 264 brain regions of interest was estimated, and undirected graphs were constructed. Network topological properties were compared using one-way repeated-measures analysis of variance. Pearson's correlation analysis assessed the relationship between the mean scores of the global network properties across network sparsity and insomnia symptoms, as measured using the global Pittsburgh Sleep Quality Index score. Results: Older adults with poor sleep quality displayed increased small-world-ness, global efficiency and modularity in the functional brain network during rest. Conversely, they exhibited decreased local efficiency, characteristic path length and clustering coefficient. In the total population, we found associations between insomnia symptoms and global network characteristics, except for betweenness centrality and modularity. Conclusions: In older adults with poor sleep quality, global network measures revealed a functional brain architecture that tended towards integration rather than segregation. Further research is needed to better understand what these findings mean about the effects of aging on poor sleep quality. © 2025 Elsevier Ltd