Flinders Health and Medical Research Institute, Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia.
CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
J Sleep Res. 2024 May;33(3):e14078. doi: 10.1111/jsr.14078. Epub 2023 Oct 19.
Previous prospective studies examining associations of obstructive sleep apnea and sleep macroarchitecture with future cognitive function recruited older participants, many demonstrating baseline cognitive impairment. This study examined obstructive sleep apnea and sleep macroarchitecture predictors of visual attention, processing speed, and executive function after 8 years among younger community-dwelling men. Florey Adelaide Male Ageing Study participants (n = 477) underwent home-based polysomnography, with 157 completing Trail-Making Tests A and B and the Mini-Mental State Examination. Associations of obstructive sleep apnea (apnea-hypopnea index, oxygen desaturation index, and hypoxic burden index) and sleep macroarchitecture (sleep stage percentages and total sleep time) parameters with future cognitive function were examined using regression models adjusted for baseline demographic, biomedical, and behavioural factors, and cognitive task performance. The mean (standard deviation) age of the men at baseline was 58.9 (8.9) years, with severe obstructive sleep apnea (apnea-hypopnea index ≥30 events/h) in 9.6%. The median (interquartile range) follow-up was 8.3 (7.9-8.6) years. A minority of men (14.6%) were cognitively impaired at baseline (Mini-Mental State Examination score <28/30). A higher percentage of light sleep was associated with better Trail-Making Test A performance (B = -0.04, 95% confidence interval [CI] -0.06, -0.01; p = 0.003), whereas higher mean oxygen saturation was associated with worse performance (B = 0.11, 95% CI 0.02, 0.19; p = 0.012). While obstructive sleep apnea and sleep macroarchitecture might predict cognitive decline, future studies should consider arousal events and non-routine hypoxaemia measures, which may show associations with cognitive decline.
先前的前瞻性研究探讨了阻塞性睡眠呼吸暂停和睡眠宏观结构与未来认知功能的关联，这些研究招募了年龄较大的参与者，其中许多人表现出基线认知障碍。本研究旨在探讨阻塞性睡眠呼吸暂停和睡眠宏观结构对年轻社区男性 8 年后视觉注意力、处理速度和执行功能的预测因素。弗洛里阿德莱德男性衰老研究参与者（n=477）接受了家庭多导睡眠图检查，其中 157 人完成了连线测试 A 和 B 以及简易精神状态检查。使用回归模型，在调整基线人口统计学、生物医学和行为因素以及认知任务表现后，评估阻塞性睡眠呼吸暂停（呼吸暂停-低通气指数、氧减饱和指数和缺氧负担指数）和睡眠宏观结构（睡眠阶段百分比和总睡眠时间）参数与未来认知功能的关联。男性的平均（标准差）年龄为 58.9（8.9）岁，其中 9.6%患有严重阻塞性睡眠呼吸暂停（呼吸暂停-低通气指数≥30 次/小时）。中位数（四分位距）随访时间为 8.3（7.9-8.6）年。只有少数男性（14.6%）在基线时认知受损（简易精神状态检查评分<28/30）。轻度睡眠比例较高与连线测试 A 表现更好相关（B=-0.04，95%置信区间[-0.06，-0.01]；p=0.003），而平均血氧饱和度较高与表现较差相关（B=0.11，95%置信区间[0.02，0.19]；p=0.012）。虽然阻塞性睡眠呼吸暂停和睡眠宏观结构可能预测认知能力下降，但未来的研究应考虑觉醒事件和非常规低氧血症指标，这些指标可能与认知能力下降有关。
