背景:睡眠纺锤体在睡眠介导的认知过程中起关键作用。众所周知,阻塞性睡眠呼吸暂停(OSA)会影响认知功能。这里,我们分析了OSA患者的注意力和执行功能,并调查了睡眠纺锤波与认知能力之间的关系。
方法:60例OSA患者(18-65岁,19名女性和41名男性)和一个对照组(n=41),包括年龄和性别匹配的健康个体。所有参与者都做了通宵多导睡眠图,和睡眠纺锤使用半自动程序进行分析。对于短期记忆的评估,注意力和执行功能,Stroop测试,在多导睡眠描记术后觉醒时,对所有参与者进行向前和向后数字跨度测试.
结果:与对照组相比,OSA患者的前向和后向数字跨度和Stroop测试的分数更差。OSA患者的睡眠纺锤体平均密度比对照组降低(p=0.044)。OSA患者的快速睡眠纺锤频率与前向手指跨度(r=2.222;p=0.038)和后向手指跨度测试得分(r=2,157;p=0.042)之间存在正相关。在中度至重度OSA患者中,睡眠纺锤体密度与正向(r=2.323,p=0.029)和反向(r=2.500,p=0.016)DST呈正相关,睡眠纺锤波持续时间与后向DST呈正相关(r=2.452,p=0.010)。
结论:我们的研究结果表明,OSA中睡眠纺锤体特征的紊乱与注意力的认知障碍有关,短期记忆,和执行功能,尤其是中度至重度OSA患者。
BACKGROUND: Sleep spindles play a key role in sleep-mediated cognitive processes. Cognitive functions are well-known to be affected in obstructive sleep apnea (OSA). Here, we analyzed attention and executive functions in patients with OSA and investigated the relationship between sleep spindles and cognitive abilities.
METHODS: Sixty patients with OSA (18-65 years, 19 females and 41 males) and a control group (n = 41) including age-and sex-matched healthy individuals were consecutively and prospectively enrolled. All participants had a full-night polysomnography, and sleep spindles were analyzed using a semi-automated program. For the evaluation of short-term memory, attention and executive functions, Stroop test, forward and backward digit span tests were applied to all participants upon awakening following polysomnography.
RESULTS: Scores of forward and backward digit span and Stroop tests were worse in OSA patients in compared to those in controls. Mean density of sleep spindles was decreased in OSA patients than those in controls (p = 0.044). A positive correlation was found between fast sleep spindle frequency and forward digit span (r = 2.222; p = 0.038) and backward digit span test scores (r = 2,157; p = 0.042) in OSA patients. In patients with moderate to severe OSA, sleep spindle density was positively correlated with forward (r = 2.323, p = 0.029) and backward (r = 2.500, p = 0.016) DSTs, and the duration of sleep spindles had positive correlation with backward DST (r = 2.452, p = 0.010).
CONCLUSIONS: Our findings demonstrated that the disturbances in sleep spindle characteristics in OSA are associated with the cognitive impairments in attention, short-term memory, and executive functions, especially in patients with moderate to severe OSA.