Department of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia.
Department of Respiratory and Sleep Medicine, Princess Alexandra Hospital, Brisbane, Australia.
Sleep Breath. 2021 Mar;25(1):75-83. doi: 10.1007/s11325-020-02050-z. Epub 2020 Mar 25.
Cognitive decline (CD) and obstructive sleep apnea (OSA) are often comorbid. Some modifiable risk factors (RF) for CD are also associated with OSA. Diagnostic polysomnography (PSG) measures these RF and may identify at risk patients prior to the onset of CD. We aim to determine whether there are severe RF associated with established CD and an increasing severity of OSA that could identify patients at risk for CD for medical intervention.
We gathered information from subjects having type 1 PSG for suspected OSA. The psychomotor vigilance task (PVT) measured established CD (group 0 and group1). We compared levels of severe RF in group 0 and group 1 with a larger group (group 2) without the PVT. We used severe standardized values of excessive daytime sleepiness (Epworth Sleepiness Score [ESS]), overnight change of systolic blood pressure (ΔSBP), change of oxygen desaturation (ΔSpO2), and sleep arousal (ArI) as RF. We compared the severe levels of ESS, ΔSBP, ΔSpO2, and ArI by group and OSA severity.
A total of 136 patients underwent diagnostic PSG. PVT parameters were available for 43 subjects. The severity of the RF was consistent with risk for CD (ΔSBP 22.0 ± 5.6, ESS 18.2 ± 2.2, ArI 58.8 ± 18.7, ΔSpO2 61.7 ± 21.9). The levels of RF increased with increasing severity of OSA. There were significant between-group differences for severe ΔSpO2 (p = 0.004) and ΔSpO2 + ArI (p = 0.019).
The levels of RF increase with increasing OSA severity. Subjects with severe RF ΔSpO2 and ΔSpO2 + ArI are likely to have PVT-determined CD. Risk factor analysis may screen for CD.
认知障碍（CD）和阻塞性睡眠呼吸暂停（OSA）通常并存。一些可改变的 CD 风险因素（RF）也与 OSA 相关。诊断性多导睡眠图（PSG）可测量这些 RF，并可在 CD 发病前识别出有风险的患者。我们旨在确定是否存在与既定 CD 相关的严重 RF 以及 OSA 严重程度的增加，从而识别出有 CD 风险的患者，以便进行医学干预。
我们从疑似 OSA 的接受 1 型 PSG 的受试者中收集信息。警觉性测试（PVT）用于测量已确立的 CD（组 0 和组 1）。我们比较了组 0 和组 1 与较大的无 PVT 组（组 2）中严重 RF 的水平。我们使用日间嗜睡过度（Epworth 嗜睡评分[ESS]）、夜间收缩压变化（ΔSBP）、氧减饱和度变化（ΔSpO2）和睡眠觉醒（ArI）的严重标准化值作为 RF。我们比较了各组和 OSA 严重程度的 ESS、ΔSBP、ΔSpO2 和 ArI 的严重程度。
共有 136 名患者接受了诊断性 PSG。43 名患者可提供 PVT 参数。RF 的严重程度与 CD 风险一致（ΔSBP 22.0±5.6、ESS 18.2±2.2、ArI 58.8±18.7、ΔSpO2 61.7±21.9）。RF 的水平随 OSA 严重程度的增加而增加。严重 ΔSpO2（p=0.004）和 ΔSpO2+ArI（p=0.019）之间存在显著的组间差异。
RF 的水平随 OSA 严重程度的增加而增加。严重 ΔSpO2 和 ΔSpO2+ArI 的患者可能有 PVT 确定的 CD。风险因素分析可能会筛查 CD。
