阻塞性睡眠呼吸暂停及快动眼睡眠期行为障碍对帕金森病患者认知功能的影响

Effects of obstructive sleep apnoea hypopnoea and rapid eye movement sleep behavior disorder on cognitive impairment in Parkinson's disease

目的观察伴阻塞性睡眠呼吸暂停(OSA)及快动眼睡眠期行为障碍(RBD)对帕金森病(PD)患者认知功能的影响。方法收集101例PD患者的临床资料,采用MMSE、蒙特利尔认知评估量表(MoCA)北京版评定患者认知功能,并对患者进行整夜多导睡眠监测(PSG)并对相关结果进行比较。结果根据PSG监测结果,将患者分为对照组34例、OSA组18例、RBD组34例及OSA+RBD组15例。与对照组比较,RBD组及OSA+RBD组MoCA评分显著降低(均P<0.05)。与OSA+RBD组比较,RBD组体质量指数及PD组Epworth嗜睡量表评分显著降低,RBD组慢波睡眠比例显著升高(均P<0.05)。与OSA组及OSA+RBD组比较,对照组及RBD组呼吸暂停低通气指数及氧减指数显著降低,最低脉搏氧饱和度显著升高(均P<0.05);OSA组的觉醒次数较其他三组显著升高(均P<0.05)。在相关分析中,PD患者的MoCA评分与RBD(r=0.324,P=0.001)、总睡眠时间(r=0.212,P=0.035)、睡眠效率(r=0.272,P=0.006)、非快速眼动睡眠2期时间(r=0.257,P=0.010)呈正相关。结论认知功能障碍在伴RBD的PD患者中很常见。PD患者认知功能与睡眠效率、总睡眠时间、非快速眼动睡眠2期时间及RBD显著相关。

Objective To observe the effects of obstructive sleep apnoea hypopnoea （ OSA ） and rapid eye movement sleep behavior disorder （RBD） on cognitive impairment in Parkinson＆#39;s disease（PD）.Methods The data of 101 PD patients were collected ,and the MMSE and Montreal Cognitive Assessment （ MoCA） were administered to assess cognitive function , then all the patients were conducted overnight polysomnography （ PSG ） , results were compared.Results All the PD patients were grouped as control group （n=34）, OSA group（n=18）, RBD group （ n=34 ） , OSA ＋RBD group （ n =15 ） by PSG.Compared with control group , MoCA scores were significantly decresed in RED and OSA ＋RBD group（all P〈0.05）.Compared with OSA＋RBD group, body mass index in RBD group and Epworth sleep scores in PD group were significantly reduced , the proportion of slow-wave sleep in RBD group was significantly increasesd （all P〈0.05）.Compared with OSA and OSA ＋RBD group, the apnea hypopnea index and oxygen desaturation index were significantly reduced , and the lowest SpO2 （ LSpO2 ） were significantly increased in the control and RED group （all P〈0.05）.OSA group exhibited higher awaking times than other three groups（all P〈0.05）.Correlation analysis showed that MoCA scores positively correlated significantly with RBD （r=0.324,P=0.001）, total sleep time （r=0.212, P=0.035）, sleep efficiency （r=0.272, P=0.006） and non-rapid eye movement sleep 2 （NREMS2） （r=0.257, P=0.010） in PD patients.Conclusions Cognitive impairment is common in PD patients with RBD .Cognitive impairment in PD patients is associated with RBD , total sleep time, sleep efficiency and NREMS2.