Zhao Jing, Kong Qianqian, Wang Minghuan, Huang Hao, Zhou Xirui, Guo Yinping, Zhang Yi, Wu Lingshan, Yu Zhiyuan, Luo Xiang
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Nat Sci Sleep. 2022 Apr 21;14:765-773. doi: 10.2147/NSS.S357586. eCollection 2022.
Excessive daytime sleepiness (EDS) and cerebral small vessel disease (CSVD) are common problems among older adults; however, their association is not clear. The present study aimed to investigate the frequency of EDS in CSVD patients and the relationship between EDS and neuroimaging markers of CSVD.
We conducted a cross-sectional study among 1076 community-dwelling older adults aged 55-85 years. EDS was measured using the Epworth Sleepiness Scale (ESS), and EDS was defined as an ESS score greater than 10. Binary logistic regression was performed to assess the association between EDS and neuroimaging markers of CSVD.
Of the 1076 participants (mean age: 65.58 ± 6.46 years, 60.5% female), the prevalence of EDS was 10.0%. EDS was more frequent in participants with CSVD than in the total sample (20.0% vs 10.0%, <0.001). In fully adjusted models, EDS was significantly correlated with CSVD burden (OR = 1.39, 95% CI 1.16 to 1.68, <0.001), the severity of white matter hyperintensities (WMH) (OR = 1.33, 95% CI 1.14 to 1.54, <0.001), and presence of lacunes (OR = 2.47, 95% CI 1.53 to 4.00, <0.001) but not with the presence of cerebral microbleeds (CMBs) (OR=1.54, 95% CI 0.92 to 2.56, = 0.099) or severity of enlarged perivascular spaces (EPVS) in basal ganglia (OR = 1.16, 95% CI 0.70 to 1.92, = 0.564).
We found a high frequency of EDS symptoms in CSVD individuals. Further, EDS was significantly associated with WMH, lacunes, and CSVD burden. Our findings further suggest patients with CSVD may exhibit abnormal sleep-wake patterns.
日间过度嗜睡（EDS）和脑小血管病（CSVD）是老年人常见的问题；然而，它们之间的关联尚不清楚。本研究旨在调查CSVD患者中EDS的发生率以及EDS与CSVD神经影像学标志物之间的关系。
我们对1076名年龄在55 - 85岁的社区居住老年人进行了一项横断面研究。使用爱泼华嗜睡量表（ESS）测量EDS，将EDS定义为ESS评分大于10分。进行二元逻辑回归以评估EDS与CSVD神经影像学标志物之间的关联。
在1076名参与者中（平均年龄：65.58±6.46岁，60.5%为女性），EDS的患病率为10.0%。CSVD参与者中EDS的发生率高于总样本（20.0%对10.0%，<0.001）。在完全调整模型中，EDS与CSVD负担（OR = 1.39，95%CI 1.16至1.68，<0.001）、白质高信号（WMH）的严重程度（OR = 1.33，95%CI 1.14至1.54，<0.001）和腔隙的存在（OR = 2.47，95%CI 1.53至4.00，<0.001）显著相关，但与脑微出血（CMB）的存在（OR = 1.54，95%CI 0.92至2.56，P = 0.099）或基底节区血管周围间隙（EPVS）扩大的严重程度（OR = 1.16，95%CI 0.70至1.92，P = 0.564）无关。
我们发现CSVD个体中EDS症状的发生率很高。此外，EDS与WMH、腔隙和CSVD负担显著相关。我们的研究结果进一步表明，CSVD患者可能表现出异常的睡眠 - 觉醒模式。
