Polysomnographic Sleep Is Associated With Time to Develop Dementia: A Study Using 19-Year VA National EHR Data
Polysomnographic Sleep Is Associated With Time to Develop Dementia: A Study Using 19-Year VA National EHR Data
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多摄影学睡眠与发展痴呆的时间有关：使用19年VA国家EHR数据的研究
DOI：
10.1093/geroni/igaa057.1520
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发表时间：
2020-12-16
影响因子：
7
通讯作者：
Naik A
中科院分区：
文献类型：
--
作者：
Nowakowski S;Razjouyan J;Sharafkhaneh A;Kunik M;Naik A
很少有研究纵向调查客观测量的睡眠和患痴呆症的时间之间的关系。这项研究利用从退伍军人管理局国家电子健康记录(VA-EHR)中提取的多导睡眠图(PSG)睡眠数据来评估睡眠与痴呆发生时间之间的关系。我们使用CPT代码从2000年到2019年识别了退伍军人事务部-EHR的61,165份PSG报告。在PSG研究后一年至2019年底的两次单独访问中，使用全原因痴呆症ICD-9/10代码记录了患痴呆症的患者，为期1年(n=1,534)。以首次出现ICD-9/10编码为痴呆发病时间，将患者分为早、中、晚3组，平均发病时间分别为2.7、7.5、12.8年。采用自然语言处理方法提取睡眠效率(SE)和入睡潜伏期(SOL)。组间比较采用单因素分析。调整年龄后，晚期组(76%)的SE显著高于早期组(69%)，晚期组(21M)的SOL显著短于早期组(33M)。与较早患痴呆症的患者相比，较晚患痴呆症的患者的SE较高，SOL较短。迟发性痴呆组的睡眠连续性更强，这表明睡眠可能是一个可改变的危险因素，可能会潜在地推迟痴呆症的发病。
Few studies have longitudinally investigated the association between objectively measured sleep and time to develop dementia. This study leverages polysomnography (PSG) sleep data extracted from the VA national electronic health records (VA-EHR) to assess the association between sleep and time to develop dementia. We identified 61,165 PSG reports from the VA-EHR from 2000 to 2019 using CPT codes. Patients who developed dementia were identified using all-cause dementia ICD-9/10 codes documented on two separate visits starting one year after the PSG study until the end of 2019 in a 1-year sliding period (n=1,534). Using the first appearance of ICD-9/10 code as dementia onset time, patients were clustered into 3 groups of early-, mid-, and late time to develop dementia (mean = 2.7, 7.5, 12.8 years, respectively). Natural language processing was used to extract sleep efficiency (SE) and sleep onset latency (SOL). Univariate analysis was used to compare the groups. After adjusting for age, SE was significantly higher in the late (76%) vs early (69%) group and SOL was significantly shorter in late (21m) versus early (33m) group. SE was higher and SOL was shorter in patients who developed dementia later compared to those who developed dementia earlier. Greater sleep continuity in late dementia onset group suggests that sleep may be a modifiable risk factor that could potentially delay the onset of dementia.