Department of Psychiatry, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China.
Department of Neurology, the Third Affiliated Hospital, Sun Yat-sen University, No. 60, Tianhe Road, Tianhe District, Guangzhou, 510630, China.
BMC Neurol. 2020 Mar 17;20(1):98. doi: 10.1186/s12883-020-01647-x.
Sleep fragmentation was shown to be positively associated with cognitive impairment in patients with cerebral small vessel disease (CSVD); however, the underlying mechanisms are not well characterized. In this study, we sought to clarify this issue by investigating the relationship between non breathing-related sleep fragmentation and brain imaging markers in patients with CSVD.
Eighty-four CSVD patients and 24 age- and sex-matched healthy controls were prospectively recruited. All subjects underwent 3.0 T superconducting magnetic resonance imaging and overnight polysomnography. Polysomnography parameters including sleep onset latency (SOL), total sleep time (TST); sleep efficiency (SE), wake after sleep onset (WASO), percentage of each sleep stage (N1, N2, N3 and rapid eye movement [REM]), arousal index (ArI), periodic limb movement in sleep index (PLSMI), and periodic limb movement related arousal index (PLMAI) were compared between CSVD patients and healthy controls. The relationship between arousal index and CSVD markers was explored in the CSVD group.
On polysomnography, CSVD patients showed significantly higher ArI, WASO, PLSMI, and PLMAI, and lower sleep efficiency and N ratio compared to healthy controls (p < 0.05). On ordinal logistic regression, higher ArI showed a positive association with the severity of periventricular white matter hyperintensity (odds ratio [OR] 1.121, 95% confidence interval [CI] 0.138-2.185) and perivascular space (OR 2.108, 95% CI 1.032-4.017) in CSVD patients, after adjusting for potential confounding variables.
These preliminary results indicate that non breathing-related sleep fragmentation is common and related to the pathological markers of CSVD patients. Future prospective research is required to determine the causal relationship between sleep parameters and CSVD pathology.
睡眠片段化与脑小血管病（CSVD）患者的认知障碍呈正相关；然而，其潜在机制尚不清楚。在这项研究中，我们通过研究 CSVD 患者非呼吸相关睡眠片段化与脑影像学标志物之间的关系来阐明这一问题。
前瞻性招募 84 例 CSVD 患者和 24 名年龄和性别匹配的健康对照者。所有受试者均接受 3.0T 超导磁共振成像和整夜多导睡眠图检查。多导睡眠图参数包括睡眠潜伏期（SOL）、总睡眠时间（TST）、睡眠效率（SE）、睡眠后觉醒（WASO）、各睡眠期百分比（N1、N2、N3 和快速眼动[REM]）、觉醒指数（ArI）、睡眠期周期性肢体运动指数（PLSMI）和睡眠期周期性肢体运动相关觉醒指数（PLMAI），并比较 CSVD 患者与健康对照组之间的差异。在 CSVD 组中，探讨了觉醒指数与 CSVD 标志物的关系。
多导睡眠图显示，CSVD 患者的 ArI、WASO、PLSMI 和 PLMAI 显著升高，睡眠效率和 N 比值显著降低（p<0.05）。在有序逻辑回归中，在校正潜在混杂因素后，较高的 ArI 与 CSVD 患者脑室周围白质高信号严重程度呈正相关（优势比[OR]1.121，95%置信区间[CI]0.138-2.185）和血管周围间隙（OR 2.108，95% CI 1.032-4.017）。
这些初步结果表明，非呼吸相关睡眠片段化在 CSVD 患者中很常见，并与 CSVD 患者的病理标志物有关。需要进一步的前瞻性研究来确定睡眠参数与 CSVD 病理之间的因果关系。
