睡眠限制对健康青少年脑血管反应性和认知结果的影响：一项试点交叉试验。

The impact of sleep restriction on cerebrovascular reactivity and cognitive outcomes in healthy adolescents: A pilot crossover trial.

作者信息

Chan Amy, Au Chun Ting, Reyna Myrtha E, Robertson Amanda, Walker Kirstin, Westmacott Robyn, Shroff Manohar, Mertens Luc, Dlamini Nomazulu, Narang Indra

机构信息

Translational Medicine, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Ontario, Canada.

Translational Medicine, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

Sleep Med. 2024 Dec;124:717-726. doi: 10.1016/j.sleep.2024.11.005. Epub 2024 Nov 9.

DOI:10.1016/j.sleep.2024.11.005

PMID:39546870

Abstract

BACKGROUND

The underlying mechanism for the association between sleep restriction (SR) and unfavorable cognitive outcomes in children and adolescents remains unclear. This study aimed to understand the effect of 5-night experimental SR on magnetic resonance imaging (MRI) measurements of cerebrovascular reactivity (CVR) and cognitive function in adolescents.

METHODS

This randomized crossover study compared two sleep conditions, SR and Control Sleep (CS) in a home setting. Healthy adolescents aged 15-18 years were recruited. The protocol began with two nights of baseline sleep to record participants' habitual sleep duration, followed by the two sleep conditions in the randomly allocated sequence, either SR (6 h in bed for 5 nights) followed by CS (9 h in bed for 5 nights), or the reverse sequence. Their sleep-wake pattern was monitored by an accelerometer and a sleep diary throughout the study period. Cerebral hemodynamics were assessed by hypercapnic challenge blood oxygen level-dependent (BOLD) MRI of CVR. Cognitive function was evaluated by NIH Toolbox Cognitive Battery on the day immediately after each sleep condition.

RESULTS

A total of 27 participants (8 males; mean age: 16.8 ± 0.7 years, range 15-18 years) were included in the study. The average sleep duration was significantly reduced in the SR condition compared to the CS condition (320 ± 34 min vs. 426 ± 45 min, p < 0.001). The CVR in the temporal occipital fusiform cortex [adjusted β(95 % CI) = -0.091(-0.010 to -0.172), p = 0.032] and occipital lobe [adjusted β(95 % CI) = -0.087 (-0.002 to -0.172), p = 0.045] was significantly lower following the SR condition when compared to the CS condition. Participants also had lower performance scores in the inhibitory control [adjusted β(95 % CI) = -6.0(-0.9 to -11.0), p = 0.019] and cognitive flexibility [adjusted β(95 % CI) = -6.6 (-1.7 to -11.6), p = 0.008] domains after the SR condition when compared to the CS condition.

CONCLUSIONS

Short-term SR is associated with poorer cognitive function possibly through reduced cerebral vasodilatory capacity in specific cognitive regions.

摘要

背景

儿童和青少年睡眠限制（SR）与不良认知结果之间关联的潜在机制尚不清楚。本研究旨在了解5晚实验性睡眠限制对青少年脑血管反应性（CVR）磁共振成像（MRI）测量和认知功能的影响。

方法

这项随机交叉研究在家庭环境中比较了两种睡眠条件，即睡眠限制（SR）和对照睡眠（CS）。招募了15 - 18岁的健康青少年。研究方案开始于两晚的基线睡眠，以记录参与者的习惯性睡眠时间，然后按照随机分配的顺序进行两种睡眠条件，要么先进行睡眠限制（连续5晚卧床6小时），接着是对照睡眠（连续5晚卧床9小时），要么顺序相反。在整个研究期间，通过加速度计和睡眠日记监测他们的睡眠 - 觉醒模式。通过高碳酸血症激发的依赖于血氧水平的功能磁共振成像（BOLD - MRI）评估脑血流动力学。在每种睡眠条件后的第二天，通过美国国立卫生研究院工具箱认知电池评估认知功能。

结果

共有27名参与者（8名男性；平均年龄：16.8 ± 0.7岁，范围15 - 18岁）纳入研究。与对照睡眠条件相比，睡眠限制条件下的平均睡眠时间显著减少（320 ± 34分钟对426 ± 45分钟，p < 0.001）。与对照睡眠条件相比，睡眠限制条件后颞枕梭状回[调整后的β（95%置信区间）= -0.091（-0.010至 -0.172），p = 0.032]和枕叶[调整后的β（95%置信区间）= -0.087（-0.002至 -0.172），p = 0.045]的脑血管反应性显著降低。与对照睡眠条件相比，睡眠限制条件后参与者在抑制控制[调整后的β（95%置信区间）= -6.0（-0.9至 -11.0），p = 0.019]和认知灵活性[调整后的β（95%置信区间）= -6.6（-1.7至 -11.6），p = 0.008]领域的表现得分也较低。