| Objective:To explore the correlation between sleep duration and neuropsychological performance and white matter hyperintensity in middle-aged and elderly patients with cerebral small vessel disease,and to provide reference for the diagnosis and treatment of cerebral small vessel disease from the perspective of sleep.Methods:1.A total of 96 middle-aged and elderly patients with cerebral small vessel disease who were hospitalized in the Department of Neurology,Second Affiliated Hospital of Nanchang University from November 2021 to November 2022 were selected as research subjects,and their basic information and clinical data were collected.Questionnaire survey,sleep related scale and portable sleep apnea monitor were used to evaluate the patients’ sleep status.The neuropsychological performance of the patients was evaluated using a battery of neuropsychological tests.According to nighttime sleep duration,they were divided into 3 groups: ≤6 hours group,(6-9)hours group,≥9 hours group.The nap duration was divided into 3 groups: no nap group,≤1 hour group,and >1 hour group.Analysis and comparison: The differences in sleep parameters and their correlation with neuropsychological scores in middleaged and elderly patients with cerebral small vessel disease with different duration of night / nap naps.To analyze and compare the differences in sleep parameters and their correlation with neuropsychological scores in middle-aged and elderly patients with cerebral small vessel disease with different night / nap duration.2.Magnetic resonance imaging(MRI)was used to evaluate the patients’ white matter lesions,which were classified into mild,moderate and severe by Fazekas score.Firstly,the correlation between sleep-related parameters and the severity of white matter hyperintensity was analyzed.Then again according to the nighttime sleep duration and nap duration group,analysis and comparison: different night /nap duration of middle-aged and elderly patients with cerebral small vessel disease and its correlation with the severity of white matter hyperintensity.Results:1.The Pittsburgh sleep quality index(PSQI)core of patients with sleep duration≤6hours was significantly higher than that of the other two groups(P=0.011,P=0.002),while the sleep efficiency was significantly lower than that of the other two groups(P<0.001,P=0.007).The Insomnia Severity Index(ISI)score of patients in the nighttime sleep duration≤6 hours group was significantly higher than that in the nighttime sleep duration≥9 hours group(P=0.002).2.There was no significant difference in sleep parameters between the different nap duration groups(P>0.05).3.The Montreal Cognitive Assessment(Mo CA)score of patients with nighttime sleep duration of(6-9)hours were significantly higher than that of the other two groups(P=0.024,P=0.002),and the Clock Drawing Test(CDT)score and Digit Span Test(DST)score were significantly higher than those of patients with nighttime sleep duration≥9 hours(P=0.001,P=0.043).Compared to patients with a nightly sleep duration of(6-9)hours,patients with a nighttime sleep duration of≥9 hours had a lower Mo CA score [β(95%CI)=-1.670(-3.371,0.030),P=0.054].4.The Self-rating Anxiety Scale(SAS)score of patients in the night sleep duration≤6 hours group was significantly higher than that in the other two groups(P=0.003,P=0.004),and the Self-rating Depression Scale(SDS)score was higher than that in the night sleep duration(6-9)hours group(P=0.036).Compared with patients with nighttime sleep duration(6-9)hours,patients with nighttime sleep duration≤6 hours had higher SAS scores [β(95%CI)=-1.670(-3.371,0.030),P=0.019].5.The Mo CA score and Auditory Verbal Learning Test(AVLT)score of patients with nap duration≤1 hour was significantly higher than those of the other two groups(P=0.004,P=0.001),and the CDT score was higher than that of patients with nap duration>1 hour(P=0.007).Compared with patients with a nap duration of≤1 hour,the Mo CA score was significantly lower in patients with a nap duration of>1hour[β(95%CI)=-5.548(-9.576,-1.300),P=0.011].6.There was no significant difference in SAS and SDS scores between different nap durations(P>0.05).7.Sleep efficiency was negatively correlated with the degree of white matter hyperintensity(r=-0.337,P=0.001),and apnea hypopnea index(AHI)index was positively correlated with the degree of white matter hyperintensity(r=0.272,P=0.007).8.There was no statistically significant correlation between different night/nap durations and the degree of white matter hyperintensity(P>0.05).Conclusion:1.In middle-aged and elderly patients with cerebral small vessel disease,patients with normal sleep duration(6-9hours)have the best overall cognitive function,whereas patients with either short sleep duration(≤6 hours)or excessive sleep duration(≥9 hours)showed decline.Patients with long sleep duration(≥9 hours)have more obvious cognitive impairment,mainly manifested as impaired visual spatial ability and attention function.2.In middle-aged and elderly patients with cerebral small vessel disease,compared with those with long nap(>1 hour)and no nap,the overall cognitive function level of patients with nap within one hour is the highest.Patients with more than one hour of nap have more obvious cognitive impairment,mainly manifested as impaired visual spatial ability and memory learning ability.3.In middle-aged and elderly patients with cerebral small vessel disease,patients with short sleep duration(≤6 hours)are more likely to suffer from anxiety than patients with normal sleep duration(6-9 hours).4.In middle-aged and elderly patients with cerebral small vessel disease,sleep efficiency and snoring are associated with the degree of white matter hyperintensity,and sleep duration is not associated with the degree of white matter hyperintensity. |
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