阻塞性睡眠呼吸暂停低通气综合征对儿童认知加工的影响

The impact of obstructive sleep apnea hypopnea syndrome on cognitive processing in children

目的:利用Das-Naglieri认知评估系统(DN:CAS)探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对儿童认知加工过程的影响。方法:选取2020年3月至2021年10月在温州医科大学附属第二医院育英儿童医院儿童睡眠医学科经多导睡眠监测确诊为OSAHS的8~13岁儿童40例为OSAHS组,同时招募健康体检儿童30例为健康对照组。采集两组儿童的一般情况(包括性别、年龄、身体质量指数等)、睡眠监测参数、DN:CAS测验量表分结果,并进行统计学分析。结果:OSAHS组1期睡眠比例、阻塞性呼吸暂停低通气指数均高于健康对照组,OSAHS组3期睡眠比例、快速眼动睡眠比例、最低动脉血氧饱和度均低于健康对照组,差异有统计学意义(P<0.05)。OSAHS组的DN:CAS 4个分测验中的计划测验、注意测验及总量表分均低于健康对照组,差异有统计学意义(P<0.05)。其中计划测验中的子测验数字匹配、计划连接,及注意测验中的子测验表达性注意、数字检测、接受性注意量表分均低于健康对照组,差异有统计学意义(P<0.05)。OSAHS组儿童的DN:CAS中的总量表分、注意测验量表分均与最低动脉血氧饱和度呈正相关(r=0.331、0.365,P<0.05)。结论:OSAHS儿童存在认知加工过程缺陷,主要表现为计划、注意加工过程缺陷,夜间低氧与注意加工过程缺陷相关。DN:CAS在应用于评估OSAHS儿童的认知过程方面,具有一定的临床实用价值。

Objective:To investigate the effects of obstructive sleep apnea hypopnea syndrome(OSAHS)on cognitive processing in children by using Das-Naglieri Cognitive assessment system(DN:CAS).Methods:Forty children aged 8-13,who were diagnosed with OSAHS by polysomnography(PSG),were selected as the OSAHS group,and 30 healthy children as the control group.The general characteristics,sleep monitoring parameters,and DN:CAS cognitive assessment results of both groups were statistically analyzed.Results:Compared with the healthy controls,the OSAHS group had a higher proportion of stage-1 sleep and obstructive apnea hypopnea index(OAHI),but lower proportion of stage-3 sleep,REM sleep,and the minimum blood oxygen saturation(LSaO_(2)),which showed statistically significant differences(P<0.05).The cognitive assessment using DN:CAS revealed that the OSAHS group had significantly lower scores in Full Scale,Planning,Matching Numbers,Planned Connections,Attention,Receptive Attention,Number Detection,and Expressive Attention,compared with the control group with statistically significant differences(P<0.05).The scores of Full Scale and Attention of DN:CAS in the OSAHS group were positively correlated with LSaO_(2)(r=0.331,0.365,P<0.05).Conclusion:Children with OSAHS exhibit deficits in cognitive processing,primarily in the areas of planning and attention.Nocturnal hypoxia is associated with attention deficits in children with OSAHS.The DN:CAS assessment system has demonstrated potential value in evaluating the cognitive processing of children with OSAHS.