阻塞性睡眠呼吸暂停低通气综合征患者认知功能与情绪及睡眠结构的关系研究  

Relationship of Cognitive Function with Emotion and Sleep Architecture in Patients with OSAHS

作　　者：刘奕姝 谭慧文 曾尹 肖莉[1,3] LIU Yishu;TAN Huiwen;ZENG Yin;XIAO Li(Sleep Medical Center,Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of Pulmonary and Critical Care Medicine,Nanchong Central Hospital,Nanchong 637003,China;Department of Pulmonary and Critical Care Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院睡眠医学中心,辽宁省沈阳市110004 [2]四川省南充市中心医院呼吸与危重症医学科,637003 [3]中国医科大学附属盛京医院呼吸与危重症医学科,辽宁省沈阳市110004

出　　处：《中国全科医学》2022年第11期1340-1345,1350,共7页Chinese General Practice

基　　金：辽宁省重点研发指导计划(2019JH8/10300006)。

摘　　要：背景阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种睡眠呼吸障碍疾病,患者长期出现夜间间歇性低氧血症和睡眠片段化,影响睡眠质量及情绪调节,这与患者认知功能有密切关联。目的探讨OSAHS患者认知功能与情绪和睡眠结构的关系。方法回顾性分析2019年9月至2020年12月在中国医科大学附属盛京医院睡眠医学中心经多导睡眠监测诊断为OSAHS的116例患者的临床资料,获得患者多导睡眠监测的数据、睡眠监测前填写的调查表〔包括焦虑筛查量表(GAD-7)、抑郁症筛查量表(PHQ-9)、蒙特利尔认知评估量表(MoCA)、记忆与执行筛查量表(MES)、失眠严重指数量表(ISI)、Epworth嗜睡量表(ESS)〕资料。根据MoCA总分将OSAHS患者分为认知正常组(MoCA总分≥26分,n=79)和认知异常组(MoCA总分<26分,n=37),应用Pearson相关分析及Spearman秩相关分析探究认知功能与各指标间的相关性,采用多元线性回归分析探究OSAHS患者认知功能的影响因素。结果认知正常组与认知异常组GAD-7、PHQ-9评分比较,差异无统计学意义(P>0.05),两组年龄、性别、MES总分、微觉醒总次数、非快眼动睡眠(NREM)期微觉醒总次数、快眼动睡眠(REM)期微觉醒总次数、总睡眠时间(TST)、睡眠后觉醒时间(WASO)、睡眠效率、N3期占总睡眠时间的百分比(N3/TST%)和REM期占总睡眠时间的百分比(REM/TST%)比较,差异有统计学意义(P<0.05)。Person相关分析/Spearman秩相关分析结果显示,MoCA总分与年龄、呼吸暂停低通气指数(AHI)、WASO呈负相关(P<0.05),与TST、睡眠效率、REM/TST%,微觉醒总次数和REM期微觉醒总次数呈正相关(P<0.05);MoCA中延迟回忆得分与年龄、WASO呈负相关(P<0.05),与睡眠效率、REM/TST%、微觉醒总次数和REM期微觉醒总次数呈正相关(P<0.05);MES总分与年龄呈负相关(P<0.05),与REM/TST%、微觉醒总次数、NREM期和REM期微觉醒总次数呈正相关(P<0.05)。多元线性回归结果Background Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a sleep-related breathing disease,which influences patients'sleep quality and emotion regulation due to long-term intermittent hypoxemia and sleep fragmentation.It has a close relationship with cognitive function.Objective To explore the relationship of cognitive function with emotion and sleep architecture in patients with OSAHS.Methods A retrospective analysis was conducted.Participants were 116 cases of OSAHS diagnosed by polysomnography(PSG)recruited from Sleep Medical Center,Shengjing Hospital of China Medical University from September 2019 to December 2020.Clinical data were collected,including results of PSG and questionnaires before PSG〔including Generalized Anxiety Disorder(GAD-7),Patient Health Questionnaire-9(PHQ-9),Montreal Cognitive Assessment(MoCA),Mean Memory and Executive Screening(MES),Insomnia Severity Index(ISI),Epworth Sleepiness Scale(ESS)〕.According to the total score of MoCA,participants were divided into normal cognition group(≥26 points,n=79)and abnormal cognition group(<26 points,n=37).Pearson and Spearman correlation analyses were used to study the correlation of cognitive function with PSG indicators.Multiple linear regression analysisi was used to explore the factors associated with cognitive function.Results There were no significant differences in emotion functions between normal cognition group and abnormal cognition group.Both groups had significant differences in mean age,sex ratio,MES score,total arousals,arousals in non-rapid eye movement(NREM),arousals in rapid eye movement(REM),total sleep time(TST),wake after sleep onset(WASO),sleep efficiency,percentage of stage N3 sleep(N3/TST%)and percentage of REM(REM/TST%)(P<0.05).Correlation analyses showed that MoCA score was negatively correlated with age,apnea hypopnea index(AHI),and WASO(P<0.05),and positively correlated with TST,sleep efficiency,REM/TST%,total arousals and arousals in REM(P<0.05).The score of delayed recall in the MoCA scale was negatively correla

关 键 词：睡眠呼吸暂停 阻塞性 认知功能 情绪 睡眠结构 影响因素分析 

分 类 号：R749.79[医药卫生—神经病学与精神病学]