背景:很少有研究评估临床前和前驱阶段AD的神经病理学标志物是否与多导睡眠图改变和阻塞性睡眠呼吸暂停(OSA)相关。
方法:这是一个横截面,在圣保罗的一所三级大学医院中,从无痴呆患者队列中随机选择的无相关临床和精神合并症的老年人(≥60岁)的病例对照研究,巴西。他们接受了临床诊断的神经心理学评估,并被分为两个样本:认知未受损(CU)和轻度认知障碍(MCI)。此外,他们接受了PET-PiB以确定淀粉样蛋白谱和通宵实验室多导睡眠图.对于每个样本,我们根据淀粉样蛋白谱(AvsA-)比较了多导睡眠图参数。
结果:我们分配了67名参与者(平均年龄73岁,SD10,1),70%女性,14±5年的教育,分为两个样本:CU(n=28,42.4%)和MCI(n=39,57.6%)。在CU样本中,A+组(n=9)的睡眠参数比A-组(n=19)差(总睡眠时间更短(p=0.007),和睡眠效率(p=0.005);较高的睡眠开始潜伏期(p=0.025),睡眠开始后的觉醒时间(p=0.011),和唤醒指数(AI)(p=0.007)),和睡眠结构的变化:更高的%N1(p=0.005),和较低的%REM(p=0.006)。在MCI示例中,MCIA具有较高的AI(p=0.013),呼吸紊乱指数(p=0.025,根据年龄控制),重度OSA的发生率高于A+。
结论:淀粉样蛋白谱与临床前AD患者睡眠质量较差的多导睡眠图标记相关,但与前驱AD无关。可能是由于严重OSA的频率较高。
BACKGROUND: Few studies have assessed whether neuropathological markers of AD in the preclinical and prodromal stages are associated with polysomnographic changes and obstructive sleep apnea (OSA).
METHODS: This was a cross-sectional, case-control study of older adults (≥60 years) without relevant clinical and psychiatric comorbidities selected randomly from a cohort of individuals without dementia in a tertiary university hospital in São Paulo, Brazil. They underwent neuropsychological evaluation for clinical diagnosis and were allocated into two samples: cognitively unimpaired (CU) and mild cognitive impairment (MCI). Also, they underwent PET-PiB to determine the amyloid profile and all-night in-lab polysomnography. For each sample, we compared polysomnographic parameters according to the amyloid profile (A+ vs A-).
RESULTS: We allocated 67 participants (mean age 73 years, SD 10,1), 70 % females, 14 ± 5 years of education, into two samples: CU (n = 28, 42.4 %) and MCI (n = 39, 57.6 %). In the CU sample, the group A+ (n = 9) showed worse sleep parameters than A- (n = 19) (lower total sleep time (p = 0.007), and sleep efficiency (p = 0.005); higher sleep onset latency (p = 0.025), wake time after sleep onset (p = 0.011), and arousal index (AI) (p = 0.007)), and changes in sleep structure: higher %N1 (p = 0.005), and lower %
REM (p = 0.006). In the MCI sample, MCI A-had higher AI (p = 0.013), respiratory disturbance index (p = 0.025, controlled for age), and higher rates of severe OSA than A+.
CONCLUSIONS: The amyloid profile was associated with polysomnographic markers of worse sleep quality in individuals with preclinical AD but not with prodromal AD, probably due to the higher frequencies of severe OSA.