Objective To explore the characteristics of sleep and brain function status in elderly patients with obstructive sleep apnea(OSA)complicated with cognitive disorder.Methods A total of 102 OSA elderly patients who visited the doctors in Guangxi Center for Diagnosis and Treatment of Sleep-Related Respiratory Diseases,the People's Hospital of Guangxi Zhuang Autonomous Region from February 2022 to October 2023 were recruited.Polysomnography monitoring parameters and brain function status data were collected,and the emotional state of the patients was assessed using Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and Symptom Checklist 90(SCL90),the sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI),and the cognitive impairment degree was assessed using Mini-Mental State Examination Scale(MMSE).The patients were divided into the OSA complicated with cognitive disorder group(with MMSE scores＜27 points)(60 cases)and the simple OSA group(with MMSE scores≥27 points)(42 cases)according to different MMSE scores.The indicators of polysomnography monitoring and the indicators of brain function status were compared between the two groups,and the correlation of MMSE scores with brain function status,polysomnography monitoring indicators and the other scales scores was analyzed.Results The scores of SDS,SCL90 and PSQI in the OSA complicated with cognitive disorder group were higher than those in the simple OSA group(P＜0.05).The MMSE scores(including orientation,memory,recall ability,language ability,attention and cal-culation ability scores)and the proportion of the patients drinking alcohol in the OSA complicated with cognitive dis-order group were significantly lower than those in the simple OSA group(P＜0.05).The proportion of N2 phase and sleep time in N2 phase in the OSA complicated with cognitive disorder group were higher than those in the simple OSA group.The apnea hypopnea index(AHI)in the non-rapid eye movement(NREM)phase and the AHI in the total sleep phase in the OSA complicated with cognitive disorder group were lower than those in the simple OSA group,and the differ-ences were significant(P＜0.05).The results of Spearman correlation analysis showed that MMSE score was nega-tively correlated with PLM index of the NREM phase(rs=-0.243,P=0.014),PLM index of the sleep phase(rs=-0.237,P=0.016),sleep time of the N2 phase(rs=-0.243,P=0.014),SDS score(rs=-0.244,P=0.014)and SAS score(rs=-0.218,P=0.028).The results of multivariate linear regression analysis showed that the sleep time of the N2 phase was related to decline in cognitive function in the OSA patients(β=-0.019,P=0.017).Conclusion The anxiety and depression of OSA patients with cognitive disorder are more obvious,and the more severe the anxiety and depression symptoms,the worse the cognitive function of the OSA patients.Depression,anxiety and other emotional problems may accelerate the cognitive decline of the OSA patients,mainly affecting the orientation,language ability,atten-tion and calculation ability of the patients.Sleep fragmentation,chronic sleep deprivation,changes in sleep structure and poor subjective sleep quality may be the main factors leading to cognitive decline in the OSA patients.
The elderlyObstructive sleep apnea(OSA)Cognitive disorderSleep structureBrain function
维普
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