Correlation Analysis Between Chronic Insomnia Disorder And Cerebral Small Vessel Disease In The Elderly

Objective: To analyze the prevalence of cerebrovascular disease and its subtypes in patients with chronic insomnia disorders at 60 years of age and above,and to explore the relationship between sleep factors and cerebral small vessel disease in patients with chronic insomnia disorder,Identify possible sleep-related influencing factors for cerebral small vessel disease.Methods:58 patients with chronic insomnia disorder(CID)who were screened by Nasal-row criteria were recruited as the case group.At the same time,60 elderly patients who had completed head MRI examination were included in the control group.All patients in the study group had improved head MRI,polysomnography(PSG),Insomnia Severity Index(ISI),and Pittsburgh Sleep Quality Index(PSQI)scores.The cases were then divided into two groups based on head MRI: cerebral small vessel disease(CSVD)and non-cerebral small vessel disease(NCSVD).Using spass19.0 software univariate analysis of the relevant factors recorded.Then,multivariate Logistic regression analysis of the factors that make a significant contribution to univariate analysis,identify possible sleep-related factors of CSVD in elderly patients with CID.Results:(1)There were 35 cases(60.3%)of CSVD patients in the case group and 25 cases(41.7%)of CSVD patients in the control group.Comparing the detection rates of CSVD in the two groups,the difference was statistically significant(p=0.042).Further,the detection rates of subtypes of CSVD,that is lacunar infarction(LI),White matter lesions(WML),cerebralmierobleeds(CMBs)and dilated Virchow-Robin Spaces(dVRS),were compared and found,there was a statistically significant difference in the detection rate of lacunar infarction between the two groups(p=0.043).(2)The statistical analysis of the insomnia process,the subjective evaluation of the sleep status,and the objective evaluation of the sleep status of the CSVD and NCSVD groups found,there were statistical differences between the two groups in the duration of insomnia,total sleep time,non-rapid eye movement sleep time,sleep efficiency,total awakening times(p<0.05).Logistic regression analysis showed that the course of disease(OR 3.244,p=0.042),total sleep time(OR 0.012,p=0.012),and sleep efficiency(OR 0.597,p=0.039)were significantly different.(3)Elderly CID patients have poor sleep quality and moderate to severe insomnia,and the disorder of sleep structure was obvious,25 patients(43.10%)had missing N3 phase.Conclusion:(1)The detection rate of CSVD in elderly CID patients is high,among which LI is common.(2)Short sleep time,low sleep efficiency,and long duration of insomnia may be the influencing factors for CSVD in elderly CID patients.(3)The disorder of sleep in patients with CID is obvious,and more patients have N3 deficiency.