老年阻塞性睡眠呼吸暂停综合征睡眠障碍特点与认知损害相关性分析

Relationship between characteristics of sleep disorder and cognitive impairment in the elderly with obstructive sleep apnea syndrome

目的分析老年阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)的睡眠障碍特点与认知损害相关性。方法受检老年人36例,分为OSAS组(18例),对照组(18例),均进行多导睡眠图(polysomnography,PSG)家庭睡眠监测、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、爱泼沃斯思睡量表(Epworth sleepiness scale,ESS)测试,检测简易智力状态(mini-mental state examination,MMSE)、记忆商(MQ)并进行画钟测验、词表学习、符号数字测验等认知功能评估。结果(1)OSAS组Delta睡眠比例减少、最低和平均血氧饱和度明显减少、呼吸暂停及低通气指数(apnea and hypopnea index,AHI)及氧减指数明显增加(P<0.05)。(2)OSAS组MMSE、MQ、符号数字测验、画钟测验成绩较差(P<0.05)。(3)OSAS组MMSE评分与年龄呈负相关(r=-0.533,P<0.05),与平均血氧水平呈正相关(r=0.409,P<0.05)。MQ与MMSE、入睡潜伏期、氧减指数相关(r分别为0.726,0.495,0.645,P均<0.05)。结论老年OSAS以深睡眠减少、血氧饱和度降低等为其睡眠障碍特点,可能是引起记忆、视空间、操作学习等认知功能损害的重要原因。

ObjectiveTo explore the relationship between obstructive sleep apnea syndrome（OSAS） and cognitive impairment in the elderly. MethodsThirtysix elderly patients were divided into two groups,eighteen patients with OSAS and 18 controls. Polysomnography at home, Pittsburgh sleep quality index（PSQI）, Epworth sleepiness scale（ESS）, minimental state examination（MMSE）,Wechsler memory scale,clock drawing,word list recall and digital symbol test were detected in two groups. ResultsThe delta sleep ratio, minimum and mean saturation of blood oxygen decreased,and the apnea and hypopnea index increased significantly in OSAS group than those in control group（P〈0.05）. Scores of the MMSE, Wechsler memory scale, digital symbol test, clock drawing in the OSAS group were impaired significantly compared with the control group. ConclusionsThe elderly with OSAS have less deep sleep and decreased blood oxygen level at night.There is a relationship between OSAS and cognitive impairment in the elderly.