Liu Hong, Wang Dexi, Li Yun, Li Zhe, Zhang Ying, Lei Fei, Du Lina, Tang Xiangdong
Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Department of Internal Medicine, First People's Hospital of Yibin, Yibin, Sichuan Province, China.
Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Department of Neurosurgery, First People's Hospital of Yibin, Yibin, Sichuan Province, China.
PLoS One. 2014 Jun 24;9(6):e100965. doi: 10.1371/journal.pone.0100965. eCollection 2014.
While individuals with insomnia consistently complain of cognitive impairment, previous studies on the effect of insomnia on objective measures of cognitive function have obtained ambiguous results. The relationship between daytime sleepiness and cognitive manifestations in insomnia patients is not clear.
Thirty-six primary insomnia patients (PIPs) and 26 good sleep controls (GSCs) with age and gender matched manner were included in the study. Participants underwent an overnight polysomnography followed by a multiple sleep latency test (MSLT) and an examination of the attention network test (ANT). ANT reflected three attentional networks including alerting, orienting and executive control. According to whether accompanied with excessive daytime sleepiness (EDS), the insomnia group were subdivided into PIPs with EDS (n = 12, score on MSLT<10 min) and PIPs without EDS (n = 24, score on MSLT≥10 min).
PIPs only performed worse on executive control function than GSCs in ANT. PIPs with EDS had longer overall reaction time (RT) related to PIPs without EDS. Further analyses with Pearson correlation analysis showed a significant negative correlation between the overall RT and MSLT latency in insomniacs (r = -0.444, p<0.01), whereas no such correlation was found in controls.
Results suggest that PIPs do show executive control function deficits compared with GSCs. Daytime sleepiness in terms of MSLT latency was associated with poor cognitive manifestations in patients with insomnia.
虽然失眠患者一直抱怨存在认知障碍，但先前关于失眠对认知功能客观测量影响的研究结果并不明确。失眠患者白天嗜睡与认知表现之间的关系尚不清楚。
本研究纳入了36名原发性失眠患者（PIPs）和26名年龄及性别匹配的良好睡眠对照者（GSCs）。参与者先进行了一夜的多导睡眠图监测，随后进行多次睡眠潜伏期测试（MSLT）和注意力网络测试（ANT）。ANT反映了包括警觉、定向和执行控制在内的三个注意力网络。根据是否伴有白天过度嗜睡（EDS），失眠组被细分为伴有EDS的PIPs（n = 12，MSLT评分<10分钟）和不伴有EDS的PIPs（n = 24，MSLT评分≥10分钟）。
在ANT测试中，PIPs仅在执行控制功能方面比GSCs表现更差。伴有EDS的PIPs与不伴有EDS的PIPs相比，总体反应时间（RT）更长。Pearson相关分析的进一步分析显示，失眠患者的总体RT与MSLT潜伏期之间存在显著负相关（r = -0.4,44，p<0.01），而对照组未发现这种相关性。
结果表明，与GSCs相比，PIPs确实存在执行控制功能缺陷。就MSLT潜伏期而言，白天嗜睡与失眠患者的认知表现不佳有关。
