Study On The Relationship Between Sleep Quality And Serum Melatonin Levels And Cognitive Function In Patients With Cerebral Small Vessel Disease

Objective:To analyze the effect of sleep on cognitive function in patients with cerebral small vessel disease and to explore its possible mechanism.To intervene the etiology of cerebral small vessel disease from the perspective of sleep,and to provide reference for the treatment of cerebral small vessel disease.Methods:1.From November 2021 to January 2023 to the 80 patients with cerebral small vessel disease were selected as subjects.Collect general basic information and general clinical data in detail;the sleep status of the patients was evaluated by using the convenient sleep breathing monitor and the sleep related scale,and the cognitive level of the patients was evaluated by using the related cognitive function scale.According to the Pittsburgh sleep quality score,the patients were divided into two groups: ≤ 7 was defined as the good sleep quality group,and > 7 was defined as the poor sleep quality group.The demographic characteristics,sociological data,and cognitive function were compared between the two groups.Multivariate regression analysis was used to analyze the correlation between sleep quality and cognitive function.2.Serum melatonin levels were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate linear regression was used to analyze the correlation between sleep quality and serum melatonin levels,serum melatonin levels and cognitive function in patients with cerebral small vessel disease.The relationship between sleep,melatonin and cognition in patients with cerebral small vessel disease was analyzed by mediation model.Results:1.In patients with cerebral small vessel disease,the detection rate of women in the poor sleep quality group was higher(66%,P < 0.05).2.In patients with cerebral small vessel disease,MOCA score,VFT score,AVLT and CDT score in poor sleep quality group were significantly lower than those in good sleep quality group(P < 0.05).3.Multivariate linear regression model After incorporating confounding factors such as gender,education level,and age,the MOCA score of the poor sleep quality group was significantly lower than that of the good sleep quality group [β(95%CI)=-4.700(-7.301,-2.100),P=0.001].4.In patients with cerebral small vessel disease,the serum melatonin level in the good sleep quality group was significantly higher than that in the poor sleep quality group(71.11 ± 18.83 vs 52.06 ± 15.23,P < 0.001).5.In patients with cerebral small vessel disease,PSQI score was negatively correlated with serum melatonin level [β(95%CI)=-1.117(-1.901,-0.332),P=0.006].6.In patients with cerebral small vessel disease,serum melatonin levels are positively correlated with MOCA scores [β(95%CI)= 0.158(0.085,0.231),P<0.001].7.In patients with cerebral small vessel disease,serum melatonin level had a mediating effect between sleep quality and cognitive function,with a 95 % confidence interval of(-0.329,-0.093),and the mediating effect accounted for 50.0 % of the total effect.Conclusion:In patients with cerebral small vessel disease,individuals with poor sleep quality have lower serum melatonin levels and worse function,mainly in visual spatial ability,language function and learning and memory function,but there is no difference in executive function.The results of this study suggest that serum melatonin may partially mediate the relationship between sleep and cognitive function in patients with cerebral small vessel disease.Good sleep may be of great significance for delaying the occurrence and development of cognitive dysfunction.