Cognitive Impairment Of Patients With Obstructive Sleep Apnea-hypopnea Syndrome And Its Infuencing Factors

Objective:1.To study the cognitive function features of adults patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and influencing factors through modified Chinese version of Montreal Cognitive Assessment(MoCA),and to explore the possible mechanism of cognitive impairment of OSAHS.2.To explore the effects of patient surgrey treatment cognitive function in obstructive sleep apnea(OSAHS) patients.Methods:Overnight Polysomnography(PSG) including apnea and hypopnea index(AHI), the lowest SaO22(LSO), sleep stage 1 to 3 and rapid eye movement sleep(REM),the Montreal Cognitive Assessment(MoCA) and the Epworth Sleepinesss Scale(ESS) had been conducted to all the patients.To complete preoperative examination to exclude surgical contraindications, modified uvulopalatopharyngoplasty treatment was used, re-examined the PSG, ESS and MoCA after 3 months.Results:112 OSAHS patients were involved into the study, and all patients received polysomnography.They were divided into three groups: mild and moderate OSAHS group, severe OSAHS group. There was no significant difference in age and years of education.The ESS score, BMI, PSG indices in severe OSAHS patients were significantly higher than the other two groups. Cognitive function was significantly different in patients with various severities of OSAHS.The MoCA total score、memory、attention and executive function in severe OSAHS group were significantly decreased compared with mild and moderate OSAHS groups.There was a negative correlation between age,ESS score、RI、ODI 、TS90%、SLT90%and MoCA total score, it had a positive correlation with the length of schooling、LSO、R/TST and MSPO2,and it had no correlation with gender、S1+S2、BMI and sleep efficiency.Among items of MoCA, the score of attention、orientation 、executive function and memory were negative correlated with AHI.There was a negative correlation between age、ESS scores、AHI、RI、ODI、TS90%、SLT90% and attention,it had a positive correlation with R/TST 、 LSO 、 MSPO2.Memory had a positive correlation with length of schooling、LSO、MSPO2,it had negative correlation with BMI、age、ODI、TS90%、SLT90%.Executive function were negative correlated with AHI、ODI、TS90%、SLT90%,and there was a positive correlation between length of schooling and naming.Orientation had a negative correlation with AHI、ODI、TS90%and SLT90%,it had a positive correlation with REM.Conclusion:OSAHS patients showed varying severities of cognitive impairment,The more sever OSAHS was,the more serious the cognitive impairment was.Cognitive impairment in OSAHS patients was associated with nighttime intermittent hypoxia.Executive function, memory and attention were associated with severity of OSAHS,it had a correlation between age,length of schooling,BMI,et al.Surgrey treatment had short-term effects, reduced daytime sleepiness, snoring symptoms, and improved patients cognition.