Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
J Neurol. 2020 Apr;267(4):1012-1022. doi: 10.1007/s00415-019-09668-4. Epub 2019 Dec 12.
To assess the prevalence of obstructive sleep apnea (OSA) in patients with mild-moderate Alzheimer's Disease (AD) and to evaluate cognitive characteristics according to the severity of OSA.
Patients with mild-moderate AD, recruited prospectively from a cognitive impairment unit, underwent overnight polysomnography. OSA was defined as an apnea-hypopnea index > 5/h. AD severity was assessed using the Mini-Mental State Examination and extensive neuropsychological battery. Epworth Sleepiness Scale and APOE status were analyzed.
The cohort included 128 patients with a median [IQR] age of 75.0 [72.0;79.2] years and 57.8% were women. OSA was diagnosed in 116 subjects (90.6%). The distribution of mild, moderate and severe severity of OSA was 29 (22.7%), 37 (28.9%) and 50 (39.1%), respectively. Regarding sleep symptoms, the cohort showed normal values of daytime sleepiness (median EES score 5 [3, 8]), while nycturia (89.1%) and snoring (71.1%) were the most common symptoms. Participants with severe OSA included a higher proportion of older men, were associated with snoring and sedentariness. No significant differences in cognitive assessment were found between patients with and without severe OSA in any of the domains. The prevalence of APOE ε4 was not significantly different between patients with and without severe OSA.
There was a high prevalence of OSA in patients with mild-moderate AD. OSA was not associated with sleepiness or worse cognitive function. APOE ε4 was not related to the presence or severity of OSA. Further longitudinal studies will be required to evaluate whether OSA impairs cognitive evolution in AD patients.
评估轻度至中度阿尔茨海默病（AD）患者中阻塞性睡眠呼吸暂停（OSA）的患病率，并根据 OSA 的严重程度评估认知特征。
前瞻性地从认知障碍病房招募轻度至中度 AD 患者，进行整夜多导睡眠图检查。OSA 定义为呼吸暂停-低通气指数>5/h。使用简易精神状态检查表和广泛的神经心理学测试包评估 AD 严重程度。分析 Epworth 嗜睡量表和 APOE 状态。
队列包括 128 名中位（IQR）年龄为 75.0 [72.0；79.2] 岁且 57.8%为女性的患者。116 名患者（90.6%）被诊断为 OSA。轻度、中度和重度 OSA 的分布分别为 29（22.7%）、37（28.9%）和 50（39.1%）。就睡眠症状而言，该队列显示白天嗜睡的正常 EES 评分中位数为 5 [3，8]，而夜尿症（89.1%）和打鼾（71.1%）是最常见的症状。严重 OSA 的参与者中，年龄较大的男性比例较高，与打鼾和久坐有关。在任何认知评估领域，严重 OSA 患者与无严重 OSA 患者之间均无显著差异。严重 OSA 患者与无严重 OSA 患者之间 APOE ε4 的患病率无显著差异。
轻度至中度 AD 患者中 OSA 的患病率很高。OSA 与嗜睡或认知功能下降无关。APOE ε4 与 OSA 的存在或严重程度无关。需要进一步的纵向研究来评估 OSA 是否会损害 AD 患者的认知演变。
