Glimmerveen A B, Bos J, Zandbergen E G J, Hofmeijer J, Keijzer H M
Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands.
Clinical Neurophysiology, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
Resusc Plus. 2025 Feb 21;22:100913. doi: 10.1016/j.resplu.2025.100913. eCollection 2025 Mar.
Long term cognitive impairment affects about half of cardiac arrest survivors, typically attributed to postanoxic encephalopathy. Sleep disorders are common after acute brain injuries and may also impair cognition. We investigated the prevalence of sleep disorders in cardiac arrest survivors and their relation with cognitive function.
Thirty survivors completed neuropsychological examination and questionnaires on mood (Hospital anxiety and depression scale), daytime sleepiness (Epworth sleepiness scale), and sleep quality (Pittsburgh sleep quality index), and underwent polysomnography one year after cardiac arrest. Questionnaire outcomes and objective sleep parameters (sleep-apnea, leg movements, cyclicity) were correlated with performance on neuropsychological tests using Pearson R, Kruskal-Wallis, or Mann-Whitney U tests.
Thirty-six percent of participants had moderate to severe obstructive sleep apnea, and 43% moderate to severe periodic limb movements during sleep according to polysomnography. Obstructive sleep apnea was correlated with poorer executive functioning ( = -0.38; < 0.05) and memory ( = -0.50; < 0.05). Fewer sleep cycles were correlated with poorer attention ( = 0.36, = 0.05). Questionnaire outcomes (mood, daytime sleepiness, sleep quality) were not related to cognition. Participants with moderate/severe obstructive sleep apnea had worse executive functioning than those with no/mild obstructive sleep apnea ( = 0.02).
This explorative study shows moderate to severe sleep disorders are common in cardiac arrest survivors and that moderate to severe obstructive sleep apnea relates to poorer cognitive function. This implies that diagnosis and treatment of obstructive sleep apnea may offer a treatment target for cardiac arrest survivors with cognitive impairment.
长期认知障碍影响约一半的心脏骤停幸存者，通常归因于缺氧后脑病。睡眠障碍在急性脑损伤后很常见，也可能损害认知。我们调查了心脏骤停幸存者睡眠障碍的患病率及其与认知功能的关系。
30名幸存者在心脏骤停一年后完成了神经心理学检查以及关于情绪（医院焦虑抑郁量表）、日间嗜睡（爱泼华嗜睡量表）和睡眠质量（匹兹堡睡眠质量指数）的问卷调查，并接受了多导睡眠监测。使用Pearson相关系数、Kruskal-Wallis检验或Mann-Whitney U检验将问卷结果和客观睡眠参数（睡眠呼吸暂停、腿部运动、周期性）与神经心理学测试表现进行关联。
根据多导睡眠监测，36%的参与者有中度至重度阻塞性睡眠呼吸暂停，43%在睡眠中有中度至重度周期性肢体运动。阻塞性睡眠呼吸暂停与较差的执行功能（r = -0.38；P < 0.05）和记忆力（r = -0.50；P < 0.05）相关。较少的睡眠周期与较差的注意力相关（r = 0.36，P = 0.05）。问卷结果（情绪、日间嗜睡、睡眠质量）与认知无关。中度/重度阻塞性睡眠呼吸暂停的参与者比无/轻度阻塞性睡眠呼吸暂停的参与者执行功能更差（P = 0.02）。
这项探索性研究表明，中度至重度睡眠障碍在心脏骤停幸存者中很常见，并且中度至重度阻塞性睡眠呼吸暂停与较差的认知功能有关。这意味着阻塞性睡眠呼吸暂停的诊断和治疗可能为有认知障碍的心脏骤停幸存者提供一个治疗靶点。
