Association of sleep-disordered breathing with decreased cognitive function among patients with dementia
Association of sleep-disordered breathing with decreased cognitive function among patients with dementia
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DOI：
10.1111/jsr.12167
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发表时间：
2014-10-01
影响因子：
4.4
通讯作者：
Yamada, Naoto
中科院分区：
文献类型：
--
作者：
Aoki, Kiyoaki;Matsuo, Masahiro;Yamada, Naoto
众所周知，睡眠对正常的认知功能至关重要。睡眠障碍，特别是睡眠呼吸障碍，是痴呆症发生的危险因素。然而，目前尚不清楚睡眠期间的呼吸不足是否与已诊断为痴呆症的患者的认知功能严重程度有关。考虑到老年人睡眠问题的高发率，确定睡眠期间呼吸不足是否会导致痴呆症是很重要的。此外，希望开发一种客观评估痴呆患者睡眠的可行方法。为此目的，采用单或双生物参数记录的简单睡眠记录器是合适的，其被定义为类型4便携式监视器。在这项研究中，使用4型睡眠记录仪评估111名痴呆患者睡眠期间的呼吸功能，并检查了与认知功能水平可能存在关系的数据。采用多因素logistic回归分析研究痴呆严重程度与睡眠呼吸障碍、年龄、糖尿病、血脂异常和高血压的关系。结果发现，呼吸紊乱指数与认知功能障碍的严重程度在我们的主题。此外，年龄小于80岁的患者比80岁或80岁以上的患者更容易出现与睡眠呼吸障碍相关的认知功能降低，因为呼吸障碍指数的增加仅与前一年龄组的认知功能恶化相关。这些结果表明，睡眠呼吸暂停的适当治疗对于保护认知功能非常重要，特别是在早期痴呆患者中。
Sleep is known to be essential for proper cognitive functioning. Sleep disturbance, especially respiratory disturbance during sleep, is a risk factor for the development of dementia. However, it is not known whether hypopnoea during sleep is related to severity of cognitive function in patients already diagnosed with dementia. Considering the high prevalence of sleep problems in aged people, it is important to determine if hypopnoea during sleep contributes to dementia. In addition, it would be desirable to develop a feasible method for objectively evaluating sleep in patients with dementia. For this purpose, a simple sleep recorder that employs single or dual bioparameter recording, which is defined as a type-4 portable monitor, is suitable. In this study, a type-4 sleep recorder was used to evaluate respiratory function during sleep in 111 patients with dementia, and data suggesting a possible relationship with cognitive function levels were examined. Multivariate logistic regression was used to investigate the association of severity of dementia with sleep-disordered breathing, age, diabetes, dyslipidaemia and hypertension. It was found that the respiratory disturbance index was associated with severity of cognitive dysfunction in our subjects. Furthermore, patients younger than 80 years were more susceptible to lower cognitive function associated with sleep-disordered breathing than patients 80 years old or over, because an increase in the respiratory disturbance index was associated with deteriorated cognitive function only in the former age group. These results suggest that proper treatment of sleep apnea is important for the preservation of cognitive function, especially in patients with early-stage dementia.