子丑睡眠与轻度认知功能障碍相关性研究

The study on the relationship between Zi-Chou sleep and mild cognitive impairment

目的 :探讨子丑睡眠(Zi-Chou sleep, ZCS)与轻度认知功能障碍(mild cognitive impairment, MCI)相关性。方法:选取2018年5月至2019年3月我院记忆障碍门诊招募的42~64岁志愿受试者,依据蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)(北京版)或听觉词语学习测验-华山版(auditory verbal learning test-Huashan version,AVLT-H),分为MCI组(98例)和正常认知(normal cognition, NC)组(112例),行匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)、Epworth嗜睡量表(Epworth sleepiness scale, ESS)和ZCS问卷了解一般睡眠和ZCS状况。结果:MCI组ESS总分显著高于NC组(Z=-2.09,P<0.05);就ZCS各因子看,ZCS时长2.5~3 h组[优势比(odds ratio, OR)=3.40,95%置信区间(confidence interval, CI):1.27~9.07]和小于2.5 h组(OR=6.79,95%CI:1.81~25.42)显著增加MCI的危险性;ZCS质量较差组(OR=2.28,95%CI:1.09~4.79)和很差组(OR=6.65,95%CI:2.18~20.32)显著增加MCI的危险性,而很差组的危险度更高;丑时早醒组(1∶00-3∶00)(OR=5.67,95%CI:2.01~16.00)发生MCI的危险度最高。进一步分析ZCS各因子与MCI的相关性,ZCS时长(OR=2.08,95%CI:1.30~3.34)的危险性大于ZCS质量(OR=1.41,95%CI:1.01~2.00)及早醒时间点(OR=1.16,95%CI:0.96~1.41)。控制混杂因素后ZCS时长是MCI的危险因素(OR=2.31,95%CI:1.35~4.00)。结论:ZCS时长是MCI的独立危险因素。

Objective To discuss the correlation between Zi-Chou sleep(ZCS) and mild cognitive impairment(MCI).Method The 42-64 year-old volunteers recruited from the memeory clinic of our hospital from May 2018 to March 2019 were selected and divided into 98 cases in the MCI group and 112 cases in the normal cognitive(NC) group according to the Montreal cognitive assessment(MoCA) scale or auditory words recall test-Huashan edition(AVLT-H). The subjects were surveyed on the Pittsburgh sleep quality index(PSQI), Epworth sleepiness scale(ESS), and ZCS questionnaire to evaluate the total sleep and ZCS status. Result The total score of ESS in MCI group was significantly higher than that in NC group(Z=-2.09,P<0.05). As far as ZCS factors are concerned, the relationship between the length of ZCS and MCI is as follows: the risk of MCI was significantly increased in the 2.5-3 h group [odds ratio(OR)=3.40, 95% confidence interval(CI)=1.27-9.07] and the less than 2.5 h group(OR=6.79, 95%CI=1.81-25.42);The relationship between ZCS quality and MCI: the risk of MCI was significantly increased in the poor sleep quality group(OR=2.28, 95%CI=1.09-4.79) and the very poor sleep quality group(OR=6.65, 95%CI=2.18-20.32). Among them, the group with very poor sleep quality has a higher risk;The relationship between early wake-up time and MCI: the risk of MCI was the highest in the group of early wake-up in period from 1 a.m. to 3 a.m.(OR=5.67, 95%CI=2.01-16.00). Further analysis of the correlation between ZCS factors and MCI, the risk of ZCS length(OR=2.08, 95%CI=1.30-3.34) was greater than the quality of ZCS(OR=1.41, 95%CI=1.01-2.00) and early wake-up time(OR=1.16, 95%CI=0.96-1.41). After controlling confounding factors, the length of ZCS was a risk factor for MCI(OR=2.31, 95%CI=1.35-4.00). Conclusions The length of ZCS is an independent risk factor for MCI.