Effect Of Obstructive Sleep Apnea Hypopnea Syndrome On Cognitive Function

Objective:To Explore the effect of obstructive sleep apnea hypopnea syndrome(OSAHS)on cognitive function and the related factors leading to cognitive dysfunction.Methods:From August 2016 to June 2018,75 patients with OSAHS were selected,from the Sleep Center of Hefei Binhu Hospital.including 68 males and 7 females,aged20-60 years,with an average age of 43(+11 years),and 33 healthy examinations during the same period,including 27 males and 6 females,aged 18-59 years,with an average age of 39(+12 years).Using self-designed demographic data questionnaire,polysomnography and Montreal Cognitive Assessment Scale,positive and reverse order digital breadth test,word fluency test,Stroop color character test,memory disorder scale,ESS sleepiness scale,self-rating depression scale,self-rating anxiety scale and so on,the general data,polysomnography and neurocognitive function of patients were compared.MoCA(> 26)was divided into normal cognitive function and MoCA < 26 into cognitive impairment.108 subjects were divided into two groups.The differences of duration,BMI,AHI,oxygen reduction index,longest pause time,minimum SaO2 and average SaO2 between the two groups were compared,and therelated factors of cognitive impairment were analyzed.Results:There was no significant difference between OSAHS group and control group in age,length of education and duration of disease(all P > 0.05),but BMI had significant difference compared with control group(P < 0.05).OSAHS group had respiratory disorder and nocturnal hypoxia.There were significant differences in respiratory disorder index,oxygen reduction index,average SaO 2,minimum SaO 2 and longest apnea time between OSAHS group and control group(P < 0.05).Compared with healthy control group,OSAHS group had longer shallow sleep time in S1 and S2,shorter sleep time in S3+4 deep sleep and REM(all P < 0.05).There were significant differences in MoCA score,positive and reverse order digit breadth test,word fluency test,memory impairment scale test and ESS sleepiness scale test compared with healthy control group(all P < 0.05),but there was no significant difference between the two groups in Stroop color character test,self-rating depression scale and self-rating anxiety scale(all P > 0.0).5).Among the indexes of MoCA scale,there was significant difference in attention between OSAHS group(P < 0.05),but there was no significant difference in visual space and execution,abstraction,delayed memory,clock drawing experiment,naming and orientation(all P > 0.05).Compared with patients with normal cognitive function(MoCA < 26),patients with cognitive impairment(MoCA < 26)hadsignificant differences in AHI,hypoxia index,longest apnea time,lowest SaO 2 and average SaO 2(P < 0.05),but there was no significant difference in duration of disease and BMI(P > 0.05).Logistic regression analysis of cognitive impairment showed that duration,BMI,AHI,hypoxia index,average SaO 2 were not correlated with cognitive impairment(P > 0.05).Cognitive impairment was positively correlated with minimum SaO 2 and longest apnea duration(r = 0.084,0.044,P = 0.046,0.009).Conclusion:Cognitive impairment was found in OSAHS group,which was mainly manifested in impaired attention,memory and executive function.Attention impairment may be an early manifestation of cognitive impairment.Nocturnal hypoxia and sleep disorder may be the main factors causing cognitive impairment in OSAHS patients,especially the lowest SaO 2 is closely related to cognitive impairment.