Carlson Barbara W, Duke James, Jones Kellie R, Carlson John R, Craft Melissa A, Coleman-Jackson Rhonda, Hershey Linda A
Res Gerontol Nurs. 2018 Nov 1;11(6):283-292. doi: 10.3928/19404921-20181003-01.
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.].
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。]
