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We investigated how early midlife sleep relates to AD\u2010related biomarkers in late midlife.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A total of 1325 adults (mean age\u00a0=\u00a040.3 years) self\u2010reported sleep quality, sleep duration, daytime sleepiness, and insomnia symptoms. Twenty years later, we assessed plasma amyloid beta (A\u03b2)42\/40, tau phosphorylated at threonine 217 (p\u2010tau217), neurofilament light chain (NfL), and magnetic resonance imaging (MRI)\u2010derived Spatial Pattern of Abnormality for Recognition of Early AD (SPARE\u2010AD), characterizing AD\u2010like brain atrophy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After multivariable adjustment, longer sleep duration was associated with lower A\u03b242\/40, poor sleep quality with higher NfL, daytime sleepiness with both lower A\u03b242\/40 and higher NfL, and insomnia symptoms with higher SPARE\u2010AD. No associations were observed with sleep and p\u2010tau217.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Poor sleep in early midlife was associated with unfavorable AD biomarker levels 20 years later, supporting the idea of sleep as a potential modifiable AD risk factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71342","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T03:06:37Z","timestamp":1776222397000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Midlife sleep characteristics and Alzheimer's disease biomarkers 20 years later"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-2307","authenticated-orcid":false,"given":"Cl\u00e9mence","family":"Cavaill\u00e8s","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California San Francisco  San Francisco California USA"},{"name":"Centre for Research in Epidemiology and Statistics (CRESS) Epidemiology of Ageing and Neurodegenerative diseases (EpiAgeing) Inserm U1153, INRAE Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes R.","family":"Carnethon","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L","family":"Knutson","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center for Circadian and Sleep Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Justin","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Neurobiology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of California San Francisco  San Francisco California USA"},{"name":"Departments of Neurology, and Epidemiology and Biostatistics University of California San Francisco and San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2310168"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(12)70291\u20100"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010024\u201012380\u20107"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsw032"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70096"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.14558"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-220924"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.0049"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.930315"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcad200"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201077830\u20104"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00989"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209988"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(88)90080\u20107"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0122138"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2010.2046908"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2013.09.010"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.11.073"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp091"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12178"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2016.39"},{"key":"e_1_2_10_23_1","unstructured":"US Food and Drug Administration.FDA Clears First Blood Test Used in Diagnosing Alzheimer's Disease.https:\/\/www.fda.gov\/news\u2010events\/press\u2010announcements\/fda\u2010clears\u2010first\u2010blood\u2010test\u2010used\u2010diagnosing\u2010alzheimersdisease(accessed February 12 2026)"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70913"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1241224"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx148"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.1173"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2024.105504"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009315"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010170032"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010220924"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aav2546"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25702"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12930"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398\u2010025\u201003389\u20101"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9574"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.683"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195\u2010019\u20100547\u20103"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2009.08.003"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.2794"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201027913\u20109"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2020.105031"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(14)70172\u20103"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22386"}],"container-title":["Alzheimer's &amp; 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