Dealberto M J, Pajot N, Courbon D, Alpérovitch A
Unité 360 Recherches Epidémiologiques en Neurologie et Psychopathologie, Institut National de la Santé et de la Recherche Médicale, Paris, France.
J Am Geriatr Soc. 1996 Nov;44(11):1287-94. doi: 10.1111/j.1532-5415.1996.tb01397.x.
To determine whether poor cognitive performance was associated with symptoms related to the sleep apnea syndrome, snoring, and breathing stoppage during sleep.
Cross-sectional analysis of data collected at baseline in the EVA Study, a 4-year cohort study.
The city of Nantes in western France.
A total of 1389 persons, aged 60 to 70 years, recruited from the electoral rolls of the city of Nantes.
Demographic characteristics and data on drug use and tobacco and alcohol consumption were collected using a standardized questionnaire. Weight and height were measured. Individuals completed a previously validated sleep questionnaire about nocturnal sleep characteristics, snoring, breathing stoppage during sleep, and day-time sleepiness. Trained psychologists administered eight neuropsychological tests: The Mini-Mental State Examination, Trail Making Test, Digit Symbol Substitution Test of the WAIS-Revised, Benton Visual Retention Test, Paced Auditory Serial-Addition Task, Auditory Verbal Learning Test, Raven Progressive Matrices, and Word Fluency Test. Depressive symptomatology was assessed by the Center for Epidemiologic Studies-Depression scale.
In this older sample, 49.5% of subjects reported snoring, and 10.8% reported breathing stoppage during sleep. Both respiratory disorders were associated significantly with male gender and high body mass index. In men, prevalence of snoring was increased significantly in those with alcohol consumption greater than 40 mL per day. Breathing stoppage during sleep was associated with depressive symptoms in women. Logistic regression models adjusted for age, gender, educational level, tobacco status and alcohol consumption, depressive symptomatology, and number of medications found that both snoring and breathing stoppage were associated with low scores (< or = 10th percentile) in tests requiring visual attention skills, the Trail Making Test (OR = 2.14, 95% CI = 1.24-3.69 and OR = 1.88, 95% CI = 1.04-3.39, respectively), and the Digit Symbol Substitution Test (OR = 1.80, 95% CI = 1.09-2.99 and OR = 1.58, 95% CI = .87-2.89, respectively). These relationships were significant only when either snoring or breathing stoppage was associated with daytime sleepiness.
This cross-sectional analysis suggested that in community-dwelling individuals 60 to 70 years of age, snoring and breathing stoppage during sleep associated with daytime sleepiness were risk factors for low cognitive performance in tests requiring visual attention skills.
确定认知功能不佳是否与睡眠呼吸暂停综合征相关症状、打鼾及睡眠期间呼吸暂停有关。
对EVA研究（一项为期4年的队列研究）基线时收集的数据进行横断面分析。
法国西部的南特市。
从南特市选民名单中招募的1389名年龄在60至70岁之间的人。
使用标准化问卷收集人口统计学特征以及药物使用、烟草和酒精消费数据。测量体重和身高。参与者完成一份先前经过验证的关于夜间睡眠特征、打鼾、睡眠期间呼吸暂停及日间嗜睡的睡眠问卷。训练有素的心理学家进行八项神经心理学测试：简易精神状态检查表、连线测验、韦氏成人智力量表修订版数字符号替换测验、本顿视觉保持测验、听觉序列加法任务、听觉言语学习测验、瑞文渐进性矩阵测验及词语流畅性测验。通过流行病学研究中心抑郁量表评估抑郁症状。
在这个老年样本中，49.5%的受试者报告有打鼾，10.8%报告有睡眠期间呼吸暂停。两种呼吸系统疾病均与男性性别和高体重指数显著相关。在男性中，每日酒精摄入量超过40毫升者打鼾患病率显著增加。睡眠期间呼吸暂停与女性抑郁症状相关。经年龄、性别、教育水平、烟草状况和酒精消费、抑郁症状及药物数量校正的逻辑回归模型显示，打鼾和呼吸暂停均与需要视觉注意力技能的测试中的低分（≤第10百分位数）相关，连线测验（比值比分别为2.14，95%可信区间为1.24 - 3.69和1.88，95%可信区间为1.04 - 3.39）及数字符号替换测验（比值比分别为1.80，95%可信区间为1.09 - 2.99和1.58，95%可信区间为0.87 - 2.89）。仅当打鼾或呼吸暂停与日间嗜睡相关时，这些关系才显著。
这项横断面分析表明，在60至70岁的社区居住个体中，与日间嗜睡相关的打鼾和睡眠期间呼吸暂停是需要视觉注意力技能的测试中认知功能低下的危险因素。
