睡眠结构、通气氧合水平与阻塞性睡眠呼吸暂停合并亚临床抑郁患者人际反应、快感及认知的关系

Relationship between sleep structure,ventilation oxygenation level and interpersonal response,pleasure and cognition in patients with obstructive sleep apnea complicated with subclinical depression

目的 通过量表评估阻塞性睡眠呼吸暂停(OSA)合并亚临床抑郁(SD)患者睡眠结构、通气氧合水平、共情(人际反应)、快感和认知灵活性,探讨睡眠数据与人际反应、快感及认知灵活性的关系。方法 选取绍兴市第七人民医院2022年5月—2023年5月门诊或住院确诊OSA合并SD患者37例作为OSA合并SD组,同期非SD的OSA患者65例作为OSA组。比较2组患者睡眠结构、睡眠通气氧合状态、共情、快感及认知灵活性等指标;并针对有差异的睡眠指标与情致认知指标间行Pearson(或Spearman)相关分析。结果 OSA合并SD患者睡眠效率(SE)与人际反应指标个人痛苦(r=-0.668)和共情关心(r=-0.579)呈负相关关系,与快感体验的抽象(r=0.664)、具体(r=0.597)预期快感和抽象完成快感(r=0.770)呈正相关关系,与认知灵活性中错误应答数(Re)、持续性错误数(Rpe)维度负向相关系数可达0.5以上。睡眠潜伏期(SL)主要与个人痛苦(r=0.546)和抽象完成快感(r=-0.574)具有一定的相关性。快速眼球运动睡眠百分比(REM%)与共情指标中的个人痛苦和大多数快感评估指标相关系数均在0.5以上,微觉醒指数则重点影响患者共情状态(均r>0.5)。呼吸暂停低通气指数(AHI)与氧减指数(ODI)同患者情致、认知指标均具有一定的相关性(均|r|>0.5)。结论 OSA合并SD患者睡眠结构、通气氧合状态对其人际反应、快感感受以及认知灵活性造成一定的影响,部分指标间存在显著相关关系。

Objective The sleep structure,ventilation oxygenation level,empathy(interpersonal response),pleasure and cognitive flexibility of patients with obstructive sleep apnea(OSA) and subclinical depression(SD)were evaluated by the scale,and the relationship between sleep data and affective cognitive indicators was explored.Methods Thirtyseven patients with confirmed outpatient or inpatient diagnosis of OSA combined with SD in the Seventh People's Hospital of Shaoxing City from May 2022 to May 2023 were selected as the OSA combined with SD group,and 65 OSA patients with non-SD during the same period were selected as the OSA group.The patients' sleep structure,sleep ventilation oxygenation status,empathy,pleasure and cognitive flexibility were compared.Pearson(or Spearman)correlation analysis was performed between different sleep indicators and emotional cognitive indicators.Results The sleep efficiency(SE)of OSA patients with SD was significantly negatively correlated with the interpersonal response indicators of personal pain(r=-0.668)and empathic concern(r=-0.579),positively correlated with the abstraction(r=0.664),concrete expected pleasure(r=0.597)and abstract completion pleasure(r=0.770)of pleasure experience,and negatively correlated with the number of error responses(Re)and the number of persistent errors(Rpe)in cognitive flexibility could reach more than 0.5.The sleep latency(SL)was mainly correlated with personal pain(r=0.546)and abstract completion pleasure(r=-0.574).The percentage of rapid eye movement sleep(REM%)were more than 0.5 correlated with personal pain and most pleasure assessment indicators in empathy indicators,and the microarousal index focused on the empathy status of patients(all r>0.5).The apnea hypopnea index(AHI)and oxygen desaturation index(ODI)were correlated with the patient's emotional and cognitive indicators(|r|>0.5).Conclusion The sleep structure and oxygenation status of OSA patients with SD have a certain impact on their interpersonal response,pleasure and cognitive flexibility,and there is a significant correlation between some indicators.