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轻度认知障碍成人睡眠期间的睡眠呼吸紊乱与脑氧合

Sleep-Disordered Breathing and Cerebral Oxygenation During Sleep in Adults With Mild Cognitive Impairment.

作者信息

Carlson Barbara W, Duke James, Jones Kellie R, Carlson John R, Craft Melissa A, Coleman-Jackson Rhonda, Hershey Linda A

出版信息

Res Gerontol Nurs. 2018 Nov 1;11(6):283-292. doi: 10.3928/19404921-20181003-01.

Abstract

The current study examined relationships between laterality in cerebral oxygenation (L-COX), sleep-disordered breathing (SDB), and daytime function in 16 adults with mild cognitive impairment (MCI). All participants underwent two nights of diagnostic polysomnography. Using dual-cerebral oximetry, L-COX was defined by differences ≥4% in right- versus left-sided percent cerebral oxyhemoglobin saturation. Eight patients had SDB. L-COX was found in five patients, but only on nights with SDB. Greater L-COX was associated more severe SDB: higher frequency of apneas + hypopneas per hour (r = 0.66, p < 0.01), desaturations per hour (r = 0.73, p < 0.01), and percent time with oxygen saturation <88% (r = 0.65, p < 0.01). Greater laterality, but not severity of SDB, was associated with poorer functional ability (Lawton Instrumental Activities of Daily Living Scale: r = -0.83, p = 0.02), lower cognitive function (Mini-Mental State Examination: r = -0.76, p = 0.03), and greater daytime sleepiness (Epworth Sleepiness Scale: r = 0.85, p < 0.001). L-COX associated with SDB suggests disruptions in cerebral autoregulation and need for aggressive treatment of SDB in individuals with MCI. [Res Gerontol Nurs. 2018; 11(6):282-292.].

摘要

本研究调查了16名轻度认知障碍(MCI)成人的脑氧合侧向性(L-COX)、睡眠呼吸紊乱(SDB)与日间功能之间的关系。所有参与者均接受了两晚的诊断性多导睡眠监测。使用双脑血氧饱和度测定法,L-COX定义为右侧与左侧脑氧合血红蛋白饱和度百分比差异≥4%。8名患者存在SDB。在5名患者中发现了L-COX,但仅在伴有SDB的夜晚出现。L-COX程度越高,与越严重的SDB相关:每小时呼吸暂停+低通气频率越高(r = 0.66,p < 0.01)、每小时血氧饱和度下降次数越多(r = 0.73,p < 0.01)以及血氧饱和度<88%的时间百分比越高(r = 0.65,p < 0.01)。L-COX程度越高而非SDB的严重程度,与较差的功能能力相关(Lawton日常生活活动能力量表:r = -0.83,p = 0.02)、较低的认知功能(简易精神状态检查表:r = -0.76,p = 0.03)以及更高的日间嗜睡程度(爱泼沃斯嗜睡量表:r = 0.85,p < 0.001)。L-COX与SDB相关表明脑自动调节功能受到破坏,且MCI患者需要积极治疗SDB。[《老年护理研究》。2018年;11(6):282 - 292。]

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