Abstract：
BACKGROUND: There are increasing data linking sleep apnea with cognitive impairment. We aimed to clarify the relationship between sleep-disordered breathing (SDB) and cognition. Detailed attention was assigned to the potential role of central versus obstructive apneic pauses in cognitive impairment.
METHODS: Patients with suspected SDB were prospectively enrolled, and a complex sleep study was performed that included overnight polysomnography. A revised version of Addenbrooke\'s Cognitive Examination (ACE-R) was used to assess cognition, evaluating overall cognition and individual subdomains.
RESULTS: A total number of 101 participants were included in the study. In multivariate binary logistic regression analysis, obstructive apnea index ([OAI], 95% CI: 1.009-1.057, p = 0.008) was the only significant contributor to the model predicting attention deficit. The proportion of N1 stage of NREM sleep was the only significant contributor to the model predicting impaired verbal fluency (95% CI: 1.004-1.081, p = 0.029). No significant differences in sleep-related indices were observed in the remaining ACE-R subdomains.
CONCLUSIONS: Except for verbal fluency and attention, we failed to find any significant association of sleep-related indices with the impairment in different cognitive subdomains. Our data suggest that impairment observed in verbal fluency is associated with a higher proportion of shallow NREM sleep, and attention deficit is associated with higher OAI. Obstructive respiratory episodes seem to play a more important role in cognitive impairment when compared to central ones.
METHODS: Patients with suspected SDB were prospectively enrolled, and a complex sleep study was performed that included overnight polysomnography. A revised version of Addenbrooke\'s Cognitive Examination (ACE-R) was used to assess cognition, evaluating overall cognition and individual subdomains.
RESULTS: A total number of 101 participants were included in the study. In multivariate binary logistic regression analysis, obstructive apnea index ([OAI], 95% CI: 1.009-1.057, p = 0.008) was the only significant contributor to the model predicting attention deficit. The proportion of N1 stage of NREM sleep was the only significant contributor to the model predicting impaired verbal fluency (95% CI: 1.004-1.081, p = 0.029). No significant differences in sleep-related indices were observed in the remaining ACE-R subdomains.
CONCLUSIONS: Except for verbal fluency and attention, we failed to find any significant association of sleep-related indices with the impairment in different cognitive subdomains. Our data suggest that impairment observed in verbal fluency is associated with a higher proportion of shallow NREM sleep, and attention deficit is associated with higher OAI. Obstructive respiratory episodes seem to play a more important role in cognitive impairment when compared to central ones.
摘要：
背景：有越来越多的数据将睡眠呼吸暂停与认知障碍联系起来。我们旨在阐明睡眠呼吸紊乱（SDB）与认知之间的关系。详细的注意力被分配到中枢和阻塞性呼吸暂停在认知障碍中的潜在作用。
方法：前瞻性纳入疑似SDB患者，进行了一项复杂的睡眠研究，包括过夜多导睡眠图。Addenbrooke的认知检查（ACE-R）的修订版用于评估认知，评估整体认知和各个子域。
结果：共101名参与者被纳入研究。在多元二元逻辑回归分析中，阻塞性呼吸暂停指数([OAI]，95%CI：1.009-1.057，p=0.008）是预测注意力缺陷的模型的唯一显著贡献者。NREM睡眠N1阶段的比例是模型预测言语流畅性受损的唯一重要因素（95％CI：1.004-1.081，p=0.029）。在其余ACE-R子域中没有观察到睡眠相关指数的显着差异。
结论：除了言语流畅和注意力，我们未能发现睡眠相关指数与不同认知亚域的损害之间存在显著关联.我们的数据表明，在言语流畅性中观察到的损害与较高比例的浅NREM睡眠有关，注意力不足与较高的OAI相关。与中枢发作相比，阻塞性呼吸发作似乎在认知障碍中起着更重要的作用。
方法：前瞻性纳入疑似SDB患者，进行了一项复杂的睡眠研究，包括过夜多导睡眠图。Addenbrooke的认知检查（ACE-R）的修订版用于评估认知，评估整体认知和各个子域。
结果：共101名参与者被纳入研究。在多元二元逻辑回归分析中，阻塞性呼吸暂停指数([OAI]，95%CI：1.009-1.057，p=0.008）是预测注意力缺陷的模型的唯一显著贡献者。NREM睡眠N1阶段的比例是模型预测言语流畅性受损的唯一重要因素（95％CI：1.004-1.081，p=0.029）。在其余ACE-R子域中没有观察到睡眠相关指数的显着差异。
结论：除了言语流畅和注意力，我们未能发现睡眠相关指数与不同认知亚域的损害之间存在显著关联.我们的数据表明，在言语流畅性中观察到的损害与较高比例的浅NREM睡眠有关，注意力不足与较高的OAI相关。与中枢发作相比，阻塞性呼吸发作似乎在认知障碍中起着更重要的作用。
