The Study Of Cognitive Disorder In Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective Using Neurocognitive function scales to evaluate the changes of cognitive function in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). And analyzing the cognitive disorder in patients by the polysomnography(PSG). In order to prompt clinical surgeons in acquiring PSG results, attention to the possible results implied in cognitive impairment of the OSAHS patients, and early intervention treatment. It has the very important significance to improve the people’s quality of life and improve the health education on prevention of patients with cognitive dysfunction.Methods 55 patients with OSAHS and 27 cases of normal control group were enrolled from southeast university affiliated Zhongda hospital otolaryngology head and neck surgery outpatient reception, as well as from the community advertising. PSG results and related cognitive function:Minimum Mental State Examination (MMSE), the Epworth Sleepiness Scale (ESS), STOP Bang Scale, complement figure test (CFT) and delayed recall (CFT DR), logical memory test (LMT) and delayed recall (LMT DR) and trail making test (TMT) were obtained. Cognitive damage in patients with OSAHS were assessed according to the result of scales and the correlation between parameters resulted from the PSG and impaired cognitive function were analyzed. Finally, the best bound values were acquired.Results① There were no significant differences in gender, age and level of education (P> 0.05);②There were significant differences in AHI, apnea index between the two groups, the longest time of apnea, low ventilation index, ODI, TST< 0.9, MSaO2, LSaO2 (P< 0.05);③There were no significant differences in sleep structure and total sleep time (P> 0.05):④ There were significant differences in directional force from MMSE scale (P< 0.05);⑤There were significant differences in ESS, STOP Bang, LMT, LMT DR (P< 0.05);⑥ Comparision between neurocognitive function scale and PSG related parameters. Results show that the AHI and apnea index are the strongest correlation parameters between neurocognitive function scale and the results of PSG; The longest time of apnea, low ventilation index, ODI, TST< 0.9, MSaO2 and LSaO2 has certain correlation with the scale, and number of awakening and snoring has no significant correlation;⑦MMSE standard for cognitive dysfunction screening validity comparison, results show that the AUC is 0.664. When the boundary value of 29.5, is the Youden index is highest, about 0.32, and the sensitivity is 76.4%, while the specificity is 55.6%;⑧ PSG validity screening, the best boundary value analysis of the parameters. The results showed that the best of apnea index value of 5.15, the longest apnea time the best value is 105 seconds, hypoventilation index is one of the best value of 0.55, the best value of 3.1, the ODI TST< 0.9 the best value of 0.27%, the best world MSaO2 value of 96.5%, LSaO2 best boundary value of 81.5%.Conclusions ① Patients with OSAHS have low ventilation and apnea at night, leading to the occurrence of cognitive dysfunction;② There were no significant differences in sleep structure and total sleep time;③ Cognitive function in patients with OSAHS exist different degree of damage, and is closely related to the severity of disease;④ Directional force, logical memory and memory ability in cognitive function in patients with OSAHS are impaired obviously;⑤ Apnea index> 5.15, and (or) the longest apnea time> 105 seconds, and (or) apnea-hypopnea index> 0.55, and (or) ODI> 3.1, and (or) TST< 0.9> 0.27%, and (or) MSaO2< 96.5%, and (or) LSaO2< 81.5%, can quickly prompt clinical doctors OSAHS patients that may have impaired cognitive function.