| Objectives:Through the subjective and objective analysis of STOP-BANG questionnaire score,Epworth score,anxiety and depression related scale,brain function monitoring and polysomnography（PSG）parameters in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）,to evaluate the relationship between sleep parameters and anxiety depression and cognitive impairment（CI）,so as to provide basis for clinical diagnosis and treatment.Methods:This study included 90 patients with OSAHS and 30 healthy controls who had completed PSG examination in the outpatient department of Bethune First Hospital of Jilin University from November 2019 to January 2022.According to ICDS-3,OSAHS patients were divided into three groups,30 cases in mild OSAHS group,30 cases in moderate OSAHS group and 30 cases in severe OSAHS group STOP-BANG questionnaire,ESS,Hamilton Anxiety and depression scale,hospital anxiety and depression scale,brain function monitoring（focusing on endogenous anxiety and internal focus）,PSG and cognitive scale were examined.The general data of the subjects were collected,including gender,age,body mass index（BMI）,years of education,smoking and drinking habits and the score of stop-bang questionnaire.The daytime sleepiness tendency of OSAHS patients was evaluated by Epworth Sleepiness Scale（ESS）.Hamilton Anxiety Scale（HAMA）,hospital anxiety and depression scale anxiety（HADA）and anxiety tendency index,Hamilton Depression Scale（HAMD）,hospital anxiety and depression scale depression（HADD）and internal focus were used to evaluate the situation of OSAHS patients with anxiety and depression.Through PSG examination,the total sleep time（TST）,sleep efficiency（%）,sleep latency,sleep arousal index,non-rapid eye movement（NREM）sleep stage（including N1,N2,N3）and rapid eye movement（REM）sleep time percentage,apnea hypopnea index（AHI）,minimum blood oxygen saturation（La SO2）,periodic limbs movement during sleep（PLMS）were analyzed Muscle relaxation during REM sleep at night.Multiple sleep latency test（MSLT）was used to objectively evaluate the degree of drowsiness,and cognitive Montreal Cognitive Assessment Scale（MOCA）was used to evaluate the cognitive function of patients.SPSS 26.0 was used to analyze the general data,PSG parameters,daytime sleepiness,anxiety,depression and other sleep disorders;The differences of general information,PSG parameters,other sleep disorders,anxiety and depression and CI between OSAHS group and control group were compared;Explore the relationship between sleep anxiety and depression.Results:1.OSAHS male accounted for 62.2%,female accounted for 37.8%;The age was48.91 ± 18.69 years;BMI was 27.15 ± 4.06;11（8,11）years of education;Smokers account for 25%;Drinkers accounted for 21.1%.2.The score of STOP-BANG questionnaire in OSAHS group was significantly higher than that in control group（4 vs.1,P < 0.001）;Among them,snoring,fatigue,apnea,hypertension,obesity（BMI > 30）and men reached the largest proportion in the severe OSAHS group.3.Changes of sleep parameters in OSAHS group: compared with the control group,N1% increased significantly（26.68 vs.4.42,P < 0.001）;N3% decreased significantly（5.40 vs.21.20,P < 0.001）;REM% decreased significantly [18.35 vs.25.10,P = 0.002;sleep efficiency decreased significantly（66.27 vs.86.50,P < 0.001）;sleep arousal index increased significantly（28.41 vs.6.00,P < 0.001）;La SO2 level decreased significantly（80.97 vs.91.4,P < 0.001）;PLMS increased significantly（3.02 vs.0.89,P < 0.001）.4.Daytime functional assessment showed that the ESS score of OSAHS group was significantly higher than that of the control group（10 vs.4.1,P < 0.001）.The average sleep time of MSLT in OSAHS group was significantly shorter than that in control group（10.7vs.20.8,P = 0.017）.5.The incidence of anxiety in OSAHS group was 67.8%,60% and 43.3%respectively;The combined rates of depressive symptoms in OSAHS group were48.9%,46.7% and 44.4%.Compared with the control group,the scores of anxiety and depression scale and brain function index in OSAHS group were significantly higher（P < 0.001）.6.The MOCA score of patients in OSAHS group was lower than that in the control group（26 vs.27,P < 0.001）.In OSAHS group,the visual space and executive function,attention and delayed memory function were significantly impaired,and the degree of damage was the most severe in severe group.7.N2%,N3%,sleep efficiency and La SO2 in PSG parameters of OSAHS patients were positively correlated with MOCA score（all P < 0.05）;And N1%,sleep arousal index,AHI and MOCA scores were negatively correlated（all P < 0.05）;There was a negative correlation between ESS score and MOCA score;There was a negative correlation between anxiety and depression index scores and MOCA scores（all P <0.05）.8.Univariate binary logistic regression analysis showed that age,years of education,BMI,TST,N1%,N2%,N3%,REM%,sleep efficiency,sleep arousal index,AHI,La SO2,ESS score in PSG parameters,HAMA and HAMD were the risk factors for CI.In multivariate binary logistic regression analysis.It was found that age（OR:1.120,95% CI: 1.025-1.224,P = 0.012）,N1%（OR: 1.702,95% CI: 1.059-2.737,P =0.028）,N2%（OR: 1.682,95% CI: 1.061-2.644,P = 0.027）and REM%（OR: 1.167,95%CI: 1.025-2.552,P = 0.003）were independent risk factors for cognitive impairment in patients with OSAHS.Conclusions:1.In OSAHS group,the sleep latency shortened,N1% increased significantly,N3%decreased significantly,REM% decreased significantly,sleep efficiency decreased significantly,sleep arousal index increased significantly,and the level of La SO2 decreased significantly.OSAHS group had obvious excessive daytime sleepiness,and the degree of sleepiness was the most serious in the severe group,which was manifested in the increase of ESS score and the shortening of MSLT average sleep time.2.The incidence rate of anxiety and depression was significantly higher in OSAHS group,and the incidence rate of anxiety and depression assessed by subjective scale was significantly higher than that assessed by objective brain function status.3.The incidence of CI in OSAHS group increased significantly.The increase of N1%,the decrease of N2%,the decrease of N3%,the increase of sleep arousal index,the increase of AHI,the decrease of La SO2,daytime dysfunction and anxiety and depression in OSAHS patients were related to the decrease of MOCA score.4.The age,N1%,N2% and REM% of OSAHS patients are the risk factors of cognitive impairment and the independent risk factors of CI. |
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