慢性失眠对客观认知功能的影响  

Effects of chronic insomnia on cognitive functions assessed objectively

作　　者：王海棠[1] 夏兰[2] 冯寅[2] 陈贵海[2] 

机构地区：[1]安徽医科大学医学心理学系,合肥研究生230022 [2]第一附属医院神经内科

出　　处：《中华保健医学杂志》2011年第2期83-86,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨失眠对客观评估的认知功能的影响。方法选取符合DSM-Ⅳ诊断标准,且匹兹堡睡眠质量指数(PSQI)>7分的慢性失眠患者124例(原发性失眠组38例、抑郁伴失眠组86例),经汉密尔顿抑郁量表17(HAMD17)评定抑郁程度后,采用蒙特利尔认知评估量表(MoCA)评定认知功能。以30例健康睡眠者为对照组。结果原发性失眠组MoCA总分和视空间/执行功能因子分显著低于对照组(Ps<0.05),抑郁伴失眠组MoCA总分和3个因子分(视空间/执行功能、语言、延迟回忆)显著低于对照组(Ps<0.05)。MoCA总分与抑郁量表的焦虑/躯体化(r=-0.243)、自知力(r=-0.293)、睡眠障碍(r=-0.293)以及PSQI中睡眠时间(r=-0.242)、睡眠效率(r=-0.258)、睡眠紊乱(r=-0.217)因子负相关(Ps<0.05)。非条件Logistics回归分析提示教育年限(β=-0.434,P<0.001)、HAMD17总分(β=0.434,P=0.009)和PSQI总分(β=0.357,P=0.029)均影响MoCA值。结论慢性失眠可损害总体认知功能。Objective To explore the changes of cognitive functions in patients with primary insomnia（PI）or comorbidity of depression and insomnia（CDI）.Methods Patients with PI and CDI were diagnosed according to DSM-Ⅳ criteria,and their Pittsburgh Sleep Quality Index（PSQI）were over 7 scores.Following evaluation of the depression severity by Hamilton Depression Rating Scale 17（HAMD17）,their cognitive functions were measured by Montreal Cognitive Assessment Scale（MoCA）.The data from the patients were compared with those from the control group.Results Compared to the controls,the overall score and factor score of visual-spatial and executive function assessed by MoCA were significantly lower in the PI group（Ps0.05）,and so were the total score and some factor scores of,i.e.,visual-spatial and executive function,language and delayed recall（Ps0.05） in the CDI group.A stronger negative correlation occurred between the total score of MoCA and some factor scores of either PSQI[sleep duration（r=-0.293）,sleep efficiency（r=-0.258）and sleep disturbances（r=-0.217）]or HAMD17（anxiety/somatization,sleep and insight）,respectively（Ps0.05）.The unconditional univariate and multivariate Logistic regression analysis showed that the cognitive function depended on the educated years（β=-0.434,P0.001）,the total scores of HAMD17（β=0.434,P=0.009）and PSQI（β=0.357,P=0.029）,respectively.Conclusions Chronic insomnia,regardless of PI or CDI,did affect the cognitive function in certain extent.

关 键 词：失眠 认知功能 抑郁 量表 

分 类 号：R338.63[医药卫生—人体生理学]