Lal Chitra, Siddiqi Nasar, Kumbhare Suchit, Strange Charlie
Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB Suite 812, Msc 630, Charleston, SC, 29425, USA,
Sleep Breath. 2015 Sep;19(3):939-45. doi: 10.1007/s11325-014-1105-7. Epub 2015 Jan 8.
Medications can impact cognitive function. Obstructive sleep apnea syndrome (OSAS) is associated with cognitive impairment. There is currently a paucity of data evaluating the impact of medications on sleep architecture and cognition in untreated OSAS. Our objective was to evaluate the impact of obstructive sleep apnea syndrome (OSAS) and medications on cognition by a screening questionnaire called the Mail-In Cognitive Function Screening Instrument (MCFSI).
We conducted a retrospective chart review on consecutive adults (age > 18 years) with OSAS seen in Medical University of South Carolina Sleep Clinic between January 1, 2012 and May 8, 2013, for whom the Mail-In Cognitive Function Screening Instrument (MCFSI) score was available and who were not on continuous positive airway pressure (CPAP). The correlation between different medications, sleep study variables, and MCFSI scores was studied.
Univariate analysis revealed that many medications had significant correlations with MCFSI scores, including antidepressants (p = 0.05), antipsychotics (p = 0.01), anxiolytics (p = 0.005), statins (p = 0.077) and narcotics (p = 0.006). The mean percentage of rapid eye movement (REM) sleep (p = 0.04) and Epworth Sleepiness Scale (p = 0.01) were also significantly correlated with MCFSI scores. Multivariate analysis revealed that Epworth Sleepiness Scale and use of antipsychotics, narcotics, and anxiolytics correlated with higher MCFSI scores (worse cognition) and conversely that statin use was associated with improved cognition.
Medications have a significant impact on cognitive function in OSAS. Thus, medication use should be considered in future studies of cognitive function in patients with OSAS.
药物会影响认知功能。阻塞性睡眠呼吸暂停综合征（OSAS）与认知障碍有关。目前，评估药物对未经治疗的OSAS患者睡眠结构和认知影响的数据较少。我们的目的是通过一种名为邮寄式认知功能筛查工具（MCFSI）的筛查问卷，评估阻塞性睡眠呼吸暂停综合征（OSAS）和药物对认知的影响。
我们对2012年1月1日至2013年5月8日期间在南卡罗来纳医科大学睡眠诊所就诊的连续成年（年龄>18岁）OSAS患者进行了回顾性病历审查，这些患者有可用的邮寄式认知功能筛查工具（MCFSI）评分且未使用持续气道正压通气（CPAP）。研究了不同药物、睡眠研究变量与MCFSI评分之间的相关性。
单因素分析显示，许多药物与MCFSI评分有显著相关性，包括抗抑郁药（p = 0.05）、抗精神病药（p = 0.01）、抗焦虑药（p = 0.005）、他汀类药物（p = 0.077）和麻醉药（p = 0.006）。快速眼动（REM）睡眠的平均百分比（p = 0.04）和爱泼沃斯嗜睡量表（p = 0.01）也与MCFSI评分显著相关。多因素分析显示，爱泼沃斯嗜睡量表以及抗精神病药、麻醉药和抗焦虑药的使用与较高的MCFSI评分（较差认知）相关，相反，他汀类药物的使用与认知改善相关。
药物对OSAS患者的认知功能有显著影响。因此，在未来OSAS患者认知功能的研究中应考虑药物使用情况。
