中-重度阻塞性睡眠呼吸暂停对认知功能及焦虑和抑郁影响的分析

The impact of severe obstructive sleep apnea on cognitive function,Anxiety,and depression:An analysis

目的:探讨阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与认知功能、抑郁及焦虑的关系,并分析影响认知功能的因素。方法:纳入2022年1月至2023年6月,安徽医科大学第三附属医院滨湖院区行多导睡眠监测(polysomnography,PSG)的患者共102例,根据PSG结果分为无或轻度OSA组及中、重度OSA组,完善蒙特利尔认知评估量表(MoCA-Beijing)、Stroop色词试验(stroop Color and Word Tset,SCWT)、数字广度测验(digit Span Test,DST)、抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS),记录各量表的评分值,并分析差异性及相关性等。结果:中-重度OSA组的颈围、BMI、SCWT-A、B、C耗时数、SIE、SAS、SDS显著高于无-轻度OSA组,MoCA视空间与执行能力、记忆、语言、抽象、延迟回忆、定向及MoCA总分、最低血氧饱和度(LSaO_(2))、平均血氧饱和度、DST-b、DST-f得分显著低于无-轻度OSA组(P均<0.05)。颈围、AHI、SAS与MoCA评分相关(OR=1.401,95%CI:1.702~1.803;OR=1.028,95%CI:1.007~1.050;OR=1.070,95%CI:0.991~1.155,P均<0.05),AHI与SDS、SAS评分相关(OR=1.001,95%CI:0.979~.025,P=0.003)。结论:中-重度OSA患者常合并认知功能障碍及抑郁、焦虑相关情绪问题,与AHI、LSaO_(2)、平均血氧饱和度指标密切相关,OSA合并焦虑与认知功能障碍具有显著相关性。

Objective:This study aimed to explore the relationship between obstructive sleep apnea(OSA)and cognitive function,as well as depression and anxiety,while analyzing the factors influencing cognitive function.Methods:A total of 102 patients who underwent polysomnography(PSG)at the Binhu Hospital of Anhui Medical University from January 2022 to June 2023 were included.Based on the PSG results,they were divided into two groups:the no or mild OSA group and the moderate or severe OSA group.The montreal cognitive assessment(MoCA-Beijing),stroop color and word test(SCWT),digit span test(DST),self-rating depression scale(SDS),and self-rating anxiety scale(SAS)were used to record and analyze the scores of each scale,as well as the differences and correlations between the groups.Results:The moderatesevere OSA group showed significantly higher values in neck circumference,BMI,SCWT-A,B,C completion times,sleep inefficiency index(SIE),SAS,and SDS compared to the no-mild OSA group.Moreover,MoCA scores for visual-spatial and executive function,memory,language,abstraction,delayed recall,orientation,total MoCA score,lowest oxygen saturation(LSaO_(2)),average oxygen saturation,DST-b,and DST-f scores were significantly lower in the moderate-severe OSA group compared to the no-mild OSA group.The differences between the groups were statistically significant(P<0.05).Neck circumference,AHI,and SAS were correlated with MoCA scores(OR=1.401,95%CI:1.702-1.803;OR=1.028,95%CI:1.007-1.050;OR=1.070,95%CI:0.991-1.155,P<0.05),while AHI was correlated with SDS and SAS scores(OR=1.001,95%CI:0.979-1.025,P=0.003).Conclusions:Moderate to severe OSA patients often exhibit cognitive impairment and related emotional problems such as depression and anxiety.These are closely related to AHI,LSaO_(2),and average oxygen saturation.OSA combined with anxiety has a significant correlation with cognitive impairment.