Department of Psychiatry, University of California, San Diego, USA.
J Clin Sleep Med. 2011 Jun 15;7(3):254-60. doi: 10.5664/JCSM.1064.
Patients with obstructive sleep apnea (OSA) commonly have cognitive complaints, particularly in attention, and report decreased quality of life. We examined how vigilance and sustained attention, as assessed by the Psychomotor Vigilance Task (PVT), were related to quality of life after controlling for apnea severity and depression in subjects with OSA.
Fifty-seven patients with newly diagnosed and untreated OSA had their sleep monitored with polysomnography. Quality of life was assessed by the Short Form-36 health survey questionnaire (SF-36). Mood was assessed by the Center for Epidemiologic Studies-Depression (CES-D) Scale. After sleep monitoring and psychological assessments were performed, the 10-minute PVT was administered. The main outcome variables were PVT lapse count and average response time (RT). Simple correlations and multiple linear regression were used to examine the association between PVT performance and age, body mass index, sleep variables, apnea hypopnea index, oxygen desaturation index, and CES-D.
Both the PVT lapse count and RT were significantly associated with the SF-36 physical component summary score (PCS). In multiple linear regression, PVT RT was an independent predictor of the SF-36 PCS (full model R(2) = 0.331, p = 0.003). PVT lapse was also an independent predictor of the SF-36 PCS (full model R(2) = 0.320, p = 0.004). However, neither PVT RT nor lapse was a significant independent predictor of the SF-36 mental component summary score (MCS). Only CES-D was an individual predictor of the SF-36 MCS (β = -0.676, p < 0.001). Impairments in sustained attention and vigilance may underlie the limitations in physical health-related quality of life reported by people with OSA, even after controlling for demographic variables, apnea severity, and depression.
阻塞性睡眠呼吸暂停（OSA）患者常出现认知主诉，尤其是注意力方面，并报告生活质量下降。我们通过多导睡眠图监测来检查警觉性和持续性注意力（通过精神运动警觉任务 [PVT] 评估）与 OSA 患者的生活质量之间的关系，这些患者在控制了呼吸暂停严重程度和抑郁后。
57 例新诊断和未经治疗的 OSA 患者进行了多导睡眠图监测。采用健康调查简表 36 项（SF-36）评估生活质量。采用流行病学研究中心抑郁量表（CES-D）评估情绪。进行睡眠监测和心理评估后，进行 10 分钟 PVT。主要观察指标为 PVT 失误数和平均反应时间（RT）。采用简单相关和多元线性回归分析 PVT 表现与年龄、体重指数、睡眠变量、呼吸暂停低通气指数、氧减指数和 CES-D 之间的关系。
PVT 失误数和 RT 与 SF-36 生理成分综合评分（PCS）显著相关。多元线性回归分析显示，PVT RT 是 SF-36 PCS 的独立预测因子（全模型 R²=0.331，p=0.003）。PVT 失误也是 SF-36 PCS 的独立预测因子（全模型 R²=0.320，p=0.004）。然而，PVT RT 和失误都不是 SF-36 心理成分综合评分（MCS）的独立预测因子。只有 CES-D 是 SF-36 MCS 的个体预测因子（β=-0.676，p<0.001）。即使在控制人口统计学变量、呼吸暂停严重程度和抑郁后，注意力和警觉性的持续性受损可能是 OSA 患者报告的与身体健康相关的生活质量受限的基础。
