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持续气道正压通气治疗对阻塞性睡眠呼吸暂停患者记忆过程的影响:一项随机假对照试验。

Continuous positive airway pressure treatment impact on memory processes in obstructive sleep apnea patients: a randomized sham-controlled trial.

作者信息

Joyeux-Faure Marie, Naegelé Bernadette, Pépin Jean-Louis, Tamisier Renaud, Lévy Patrick, Launois Sandrine H

机构信息

HP2 Unit, Inserm U1042, Grenoble Alpes University, Grenoble, France; Department of Physiology and Sleep, Grenoble University Hospital, Grenoble, France.

Neuro-Vascular Department, Grenoble University Hospital, Grenoble, France; Inserm U836, Grenoble Neurosciences Institut, Grenoble, France.

出版信息

Sleep Med. 2016 Aug;24:44-50. doi: 10.1016/j.sleep.2016.06.023. Epub 2016 Aug 23.

Abstract

OBJECTIVE

The aim of this study was to investigate the changes in a large panel of memory processes after six weeks of continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA) patients. This randomized controlled trial compared the influence of effective CPAP to sham CPAP over six weeks on different memory processes in OSA patients.

METHODS

The study took place in a sleep laboratory and outpatient sleep clinic in a French tertiary-care university hospital. A total of 36 patients with OSA were randomized to receive either CPAP (n = 18) or sham CPAP (n = 18) for six weeks. Interventions were either effective CPAP or non-effective sham CPAP, for six weeks. All patients underwent an extensive battery of tasks evaluating three separate memory systems, before and after treatment. Verbal episodic memory was tested after forced encoding, procedural memory was tested using simplified versions of mirror drawing and reading tests, and working memory was examined with validated paradigms based on a theoretical model.

RESULTS

The study subjects were 55 ± 11 years of age and 72.2% were male. The mean body mass index was 29.5 ± 4.1 kg/m and the apnea-hypopnea index was 37.1 ± 16.3/h. Prior to treatment, memory performances of OSA patients were altered. In an intention-to-treat analysis, memory deficits were not significantly improved after six weeks of effective CPAP compared to sham CPAP treatment. Verbal episodic, procedural, and working memory scores were comparable between both groups.

CONCLUSION

Using cautious methodology in comparing effective CPAP to sham CPAP and a well-defined set of memory assessments, we did not find improvement in memory performance after six weeks of treatment.

摘要

目的

本研究旨在调查阻塞性睡眠呼吸暂停(OSA)患者连续接受六周持续气道正压通气(CPAP)治疗后一系列记忆过程的变化。这项随机对照试验比较了有效CPAP与假CPAP在六周内对OSA患者不同记忆过程的影响。

方法

该研究在法国一家三级护理大学医院的睡眠实验室和门诊睡眠诊所进行。共有36例OSA患者被随机分为两组,分别接受CPAP治疗(n = 18)或假CPAP治疗(n = 18),为期六周。干预措施为有效CPAP或无效假CPAP,持续六周。所有患者在治疗前后均接受了一系列广泛的任务测试,以评估三个独立的记忆系统。言语情景记忆在强制编码后进行测试,程序记忆通过简化版的镜像绘图和阅读测试进行测试,工作记忆则根据理论模型使用经过验证的范式进行检查。

结果

研究对象的年龄为55±11岁,72.2%为男性。平均体重指数为29.5±4.1kg/m²,呼吸暂停低通气指数为37.1±16.3/h。治疗前,OSA患者的记忆表现有所改变。在意向性分析中,与假CPAP治疗相比,有效CPAP治疗六周后记忆缺陷并未得到显著改善。两组的言语情景记忆、程序记忆和工作记忆得分相当。

结论

在将有效CPAP与假CPAP进行比较时采用了谨慎的方法,并使用了一套明确的记忆评估方法,我们发现治疗六周后记忆表现并未改善。

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