轻度认知功能障碍患者睡眠特征及其与认知功能的相关性分析

孙棋圻; 高可润

doi:10.16766/j.cnki.issn.1674-4152.002993

轻度认知功能障碍患者睡眠特征及其与认知功能的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.002993

孙棋圻^,,
高可润

杭州市第七人民医院浙江大学医学院附属精神卫生中心精神二科，浙江杭州 310013

基金项目:

浙江省医药卫生科技计划项目 2021RC025

详细信息

通讯作者:
孙棋圻，E-mail：dengage@163.com

中图分类号: R749.1
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出版历程
- 收稿日期: 2022-12-05

Sleep characteristics and their correlation with cognitive function in patients with mild cognitive impairment

SUN Qiqi^,,
GAO Kerun

Second Department of Psychiatry, Hangzhou Seventh People ' s Hospital, Affiliated Mental Health Center of Zhejiang University Medical College, Hangzhou, Zhejiang 310013, China

摘要

摘要: 目的通过对轻度认知功能障碍(MCI)患者的睡眠特征进行分析，然后分析MCI与认知功能的关系，为延缓MCI患者的认知功能障碍提供依据。方法选取2019年2月—2022年2月在我院治疗的MCI患者和同期健康体检者各72例作为观察组和对照组。比较2组睡眠和认知功能，分析睡眠特征与认知功能的相关性。结果观察组睡眠障碍发生率(44.44%)明显高于对照组(13.89%, P < 0.01)；观察组爱泼沃斯睡眠量表(ESS)评分、匹兹堡睡眠质量指数(PSQI)总分以及PSQI量表主观睡眠时间、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍等项目评分均明显高于对照组(均P < 0.01)；观察组浅睡眠期(S1+S2)%占比明显高于对照组(P < 0.01)，而深睡眠期(S3+S4)、快速动眼期(REM)睡眠时间、REM睡眠占比明显低于对照组(均P < 0.01)；观察组蒙特利尔认知功能评估量表(Mo-CA)总分及Mo-CA量表中定向、记忆、视空间和执行功能、命名、语言、注意、抽象概括等项目评分均明显低于对照组(均P < 0.01)；ESS评分、PSQI总分、PSQI量表中的睡眠质量、入睡时间、睡眠时间、睡眠效率、夜间睡眠障碍、日间功能障碍以及S3+S4(%)、REM睡眠占比与Mo-CA评分呈负相关关系(r=-0.329~-0.213，P=0.001~0.036)。结论 MCI患者存在更高比例的睡眠障碍，患者睡眠障碍与认知功能具有显著相关性，患者睡眠质量越差，其深度睡眠期和REM期睡眠越短，认知功能也越差。
- 轻度认知功能障碍 /
- 睡眠障碍 /
- 认知功能 /
- 相关性
Abstract: Objective To analyze the sleep characteristics of patients with mild cognitive impairment (MCI), and then analyze the relationship between MCI and cognitive function, so as to provide a basis for delaying cognitive dysfunction in MCI patients. Methods A total of 72 MCI patients treated in Hangzhou Seventh People ' s Hospital from February 2019 to February 2022 and 72 healthy physical examiners in the same period were selected as the observation group and control group, respectively. The sleep and cognitive function were compared between the 2 groups, and the correlation between sleep characteristics and cognitive function was also analyzed. Results The incidence of sleep disorders in the observation group (44.44%) was significantly higher than that in the control group (13.89%, P < 0.01). Epworth sleep scale (ESS) scores, Pittsburgh sleep quality index (PSQI) total scores, PSQI subjective sleep time, sleep duration, sleep efficiency, sleep disturbance, daytime dysfunction and other scores were significantly higher in the observation group than in the control group (all P < 0.01). The proportion of light sleep (S1+S2) % in the observation group was significantly higher than that in the control group (P < 0.01), while deep sleep period (S3+S4), rapid eye movement (REM) sleep and the proportion of REM sleep in the observation group were significantly lower than that in the control group (all P < 0.01). The total score of Montreal cognitive function assessment scale (Mo-CA) and scores of orientation, memory, visuospatial and executive function, naming, language, attention, abstract generalization and other items in Mo-CA were significantly lower in observation group than in control group (all P < 0.01). ESS score, PSQI total score, PSQI sleep quality, time to fall asleep, sleep duration, sleep efficiency, nighttime sleep disturbance, daytime dysfunction, S3+S4 (%) and the proportion of REM sleep in the PSQI scale were significantly negatively correlated with and Mo-CA scores (r was -0.329 to -0.213, P value was 0.001 to 0.036). Conclusion MCI patients have a higher proportion of sleep disorders, and there is a significant correlation between sleep disorders and cognitive function. The worse the sleep quality of patients, the shorter their deep sleep and REM sleep, and the worse their cognitive function.
- Mild cognitive impairment /
- Sleep disorders /
- Cognitive function /
- Correlation
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表 1 2组MCI患者睡眠障碍发生状况比较[例(%)]

Table 1. Comparison of the occurrence of sleep disordersin the 2 groups of MCI patients[cases (%)]

组别	例数	睡眠障碍	无睡眠障碍
观察组	72	32(44.44)	40(55.56)
对照组	72	10(13.89)	62(86.11)
注：2组睡眠障碍发生情况比较，χ²=16.269，P < 0.001。

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表 2 2组MCI患者睡眠质量测评比较(x±s，分)

Table 2. Comparison of sleep quality measures between the 2 groups of MCI patients(x±s, points)

组别	例数	ESS评分	PSQI总分	主观睡眠质量	入睡时间	睡眠时间	睡眠效率	夜间睡眠障碍	日间功能障碍	使用催眠药物
观察组	72	8.45±1.86	11.79±2.13	4.37±0.35	1.62±0.16	6.52±0.41	1.61±0.75	1.92±0.43	1.87±0.53	0.43±0.12
对照组	72	5.68±1.92	7.36±2.35	3.51±0.52	1.25±0.25	5.36±0.37	1.28±0.63	1.62±0.65	0.98±0.49	0.39±0.25
t值		8.879	11.852	11.642	10.577	17.823	2.859	3.266	10.463	1.224
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	0.005	0.001	< 0.001	0.223

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表 3 2组MCI患者睡眠监测相关指标比较(x±s)

Table 3. Comparison of sleep monitoring related indicatorsbetween the two groups of MCI patients(x±s)

组别	例数	S1+S2(%)	S3+S4(%)	REM睡眠时间(min)	REM睡眠占比(%)
观察组	72	82.61±3.73	2.51±0.27	61.52±2.67	15.72±1.62
对照组	72	68.76±3.83	4.75±0.58	83.98±2.86	25.89±2.85
t值		21.982	-29.709	-48.709	-26.324
P值		< 0.001	< 0.001	< 0.001	< 0.001

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表 4 2组MCI患者认知功能评分比较(x±s，分)

Table 4. Comparison of Cognitive function scores between the two groups of MCI patients(x±s, points)

组别	例数	定向力	记忆力	视功能与执行功能	命名	语言	注意	抽象	Mo-CA总分
观察组	72	5.63±1.73	2.62±0.61	3.51±0.65	2.75±0.51	2.82±0.87	4.13±0.36	1.78±0.45	22.67±2.53
对照组	72	6.65±1.71	4.16±0.52	4.37±0.82	4.83±0.85	3.75±0.85	5.27±0.35	2.63±0.79	28.97±2.78
t值		-3.558	-16.302	-6.974	-17.805	-6.488	-19.266	-7.933	-14.222
P值		0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

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表 5 MCI患者睡眠质量相关指标与Mo-CA评分之间的相关性

Table 5. Correlation between sleep quality-related indicators and Mo-CA scores in MCI patients

统计量	ESS评分	PSQI总分	睡眠质量	入睡时间	睡眠时间	睡眠效率	夜间睡眠障碍	日间功能障碍	催眠药物	S1+S2(%)	S3+S4(%)	REM睡眠占比
r值	-0.312	-0.329	-0.243	-0.287	-0.291	-0.223	-0.285	-0.281	-0.116	-0.143	-0.213	-0.255
P值	0.002	0.001	0.016	0.004	0.004	0.029	0.005	0.005	0.242	0.162	0.036	0.012

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