多导睡眠图
阻塞性睡眠呼吸暂停
非快速眼动睡眠
蒙特利尔认知评估
听力学
睡眠阶段
认知
调解
睡眠呼吸暂停
睡眠剥夺对认知功能的影响
心理学
内科学
医学
呼吸暂停
脑电图
精神科
认知障碍
政治学
法学
作者
Andrew E. Beaudin,Magdy Younes,Bethany Gerardy,Jill K. Raneri,Angier Allen,Teresa Gomes,Simon Gakwaya,Frédéric Sériès,John Kimoff,Robert Skomro,Najib Ayas,Eric E. Smith,Patrick J. Hanly
出处
期刊:Sleep
[Oxford University Press]
日期:2024-06-29
标识
DOI:10.1093/sleep/zsae141
摘要
Abstract Study Objectives Obstructive sleep apnea (OSA) increases the risk of cognitive impairment. Measures of sleep microarchitecture from EEG may help identify patients at risk of this complication. Methods Participants with suspected OSA (n=1142) underwent in-laboratory polysomnography and completed sleep and medical history questionnaires, and tests of global cognition (Montreal Cognitive Assessment, MoCA), memory (Rey Auditory Verbal Learning Test, RAVLT) and information processing speed (Digit–Symbol Coding, DSC). Associations between cognitive scores and stage 2 NREM sleep spindle density, power, frequency and %-fast (12-16Hz), odds-ratio product (ORP), normalized EEG power (EEGNP) and the delta:alpha ratio were assessed using multivariable linear regression (MLR) adjusted for age, sex, education, and total sleep time. Mediation analyses were performed to determine if sleep microarchitecture indices mediate the negative effect of OSA on cognition. Results All spindle characteristics were lower in participants with moderate and severe OSA (p≤0.001, versus no/mild OSA) and positively associated with MoCA, RAVLT and DSC scores (false discovery rate corrected p-value, q≤0.026), except spindle power which was not associated with RAVLT (q=0.185). ORP during NREM sleep (ORPNREM) was highest in severe OSA participants (p≤0.001) but neither ORPNREM (q≥0.230) nor the delta:alpha ratio were associated with cognitive scores in MLR analyses (q≥0.166). In mediation analyses, spindle density and EEGNP (p≥0.048) mediated moderate-to-severe OSA’s negative effect on MoCA scores while ORPNREM, spindle power and %-fast spindles mediated OSA’s negative effect on DSC scores (p≤0.018). Conclusion Altered spindle activity, ORP and normalized EEG power may be important contributors to cognitive deficits in patients with OSA.
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