摘要
目的 系统评价睡眠与轻度认知障碍(mild cognitive impairment,MCI)的关系,为通过睡眠指标诊断MCI、阿尔茨海默病(Alzheimer's disease,AD)提供依据.方法 对PubMed、Medline、Cochrane图书馆等数据库进行了系统搜索,确定检索建库至2022年4月前发表的关于睡眠与MCI之间关系的相关文章.使用随机效应模型计算标准均值差(standardized mean differences,SMD)和95%置信区间(confidence intervals,CI).结果 总体荟萃分析显示11项观察性研究(共1916名参与者),提供了4个SMD,入睡后觉醒时间(wake-time after sleep onset,WASO)组(SMD=9.61,95%CI:4.18～15.05,P=0.04);快速眼动(rapid eye movement,REM)睡眠组(SMD=-1.93,95%CI:-2.70～-1.16,P=0.009),慢波睡眠(slow wave sleep,SWS)组(SMD=-0.65,95%CI:-0.82～-0.47,P=0.90),睡眠效率(sleep efficiency,SE)组(SMD=-4.36,95%CI:-5.98～-2.75,P=0.39).结论 MCI患者存在睡眠障碍,REM睡眠和SWS时间缩短,SE减少,WASO增加.有睡眠问题的个体患AD、认知障碍和临床前AD的比没有睡眠问题的个体的风险高,证实了改善睡眠可提高认知水平,延缓认知障碍发展.
Abstract
Objective To systematically evaluate the relationship between sleep and mild cognitive impairment(MCI)and to provide a basis for the diagnosis of MCI and Alzheimer's disease(AD)by sleep indicators.Methods A systematic search of PubMed,Medline,and the Cochrane Library was conducted to identify relevant articles on the relationship between sleep and MCI published between the search build and April 2022.Standardized mean differences(SMD)and 95%confidence intervals(CI)were calculated using ran-dom effects models.Results The overall meta-analysis showed 11 observational studies(1916 partici-pants)that provided four SMD for the wake-time after sleep onset(WASO)group(SMD=9.61,95%CI:4.18-15.05,P=0.04);rapid eye movement(REM)sleep group(SMD=-1.93,95%CI:-2.70--1.16,P=0.009),slow wave sleep(SWS)group(SMD=-0.65,95%CI:-0.82--0.47,P=0.90),and sleep effi-ciency(SE)group(SMD=-4.36,95%CI:-5.98--2.75,P=0.39).Conclusion Patients with MCI have sleep disorders with reduced duration of rapid eye movement and slow wave sleep,reduced SE,and in-creased WASO.Individuals with sleep problems had an increased risk of AD,cognitive impairment and pre-clinical AD than those without sleep problems.It was confirmed that improved sleep pairs can improve cog-nition and delay the development of cognitive impairment.
维普
万方数据