Detection Rate And Treatment Effect Of Mild Cognitive Impairment In Patients With Obstructive Sleep Apnea Syndrome And Hypertension

Objective: To investigate the detection rate and treatment effect of mild cognitive impairment(MCI)in patients with obstructive sleep apnea syndrome(OSAS)and hypertension.Methods: 1.This study continuously collected patients with suspected OSAS who were hospitalized in the Hypertension Center of the People’s Hospital of Xinjiang Uygur Autonomous Region from April 2021 to December 2022,and improved overnight polysomnography(PSG)and 24-hour ambulatory blood pressure monitoring.120 patients with OSAS(29 severe,48 moderate,and 43 mild)and hypertension were included in the study.They were evaluated with the Montreal Cognitive Assessment(Mo CA),with a Mo CA score of<26 defined as MCI,Calculate the detection rate of MCI and the clinical characteristics of the population.2.In order to further observe the efficacy of continuous positive airway pressure(CPAP)in the treatment of MCI,on the basis of oral antihypertensive drugs,25 patients(8 cases of moderate OSAS and 17 cases of severe OSAS)who adhered to CPAP treatment for 3 months,agreed to and successfully completed the Mo CA assessment before and after treatment were included to observe the changes in cognitive function before and after CPAP treatment.Results: 1.The detection rate of MCI in OSAS patients with hypertension is 67.5%.Compared with the group with normal cognitive function,the MCI group showed an increase in AHI [20.1(15.3,31.6)vs.6.7(2.6,26.1)pers/h],T90 [27.2(5.3,80.4)vs.6.9(0.4,79.1)minutes].lowest oxygen saturation at night [81.0(77.0,85.0)vs.86.0(79.0,88.0)%],attention [(5.2±0.9)vs.(5.7±1.2)points],delayed recall [(2.2±1.3)vs.(3.6±0.9)points],abstract thinking [(0.9±0.74)vs.(1.6±0.55)points] significantly reduced(P<0.05 for all).Multiple logistic regression showed that the lowest oxygen saturation at night and phase 1 sleep(N1%)were independent risk factors for MCI in this population.The paired sample T-test results showed that compared with before CPAP treatment,the total score of MOCA [(23.12±1.48)vs(26.12±2.09)] significantly increased after treatment,while the daily average systolic blood pressure [(139.36±15.97)vs(136.00±11.39)] and daily average diastolic blood pressure [(90.40±9.90)vs(85.60±11.23)] decreased slightly,with statistically significant differences(P<0.05);Further comparison of cognitive dimensions showed that visual space/executive function [(3.16±0.80)vs.(3.56±1.00)] and delayed recall [(2.36±1.04)vs.(4.28±0.98)] were significantly increased(P<0.05);BMI [(28.78±3.57)vs(28.67±3.44)]decreased,but the difference was not statistically significant(P>0.05).Conclusions: 1.The prevalence of MCI in OSAS patients with hypertension is high,mainly manifested in attention,delayed memory,and abstract thinking;Lowering nocturnal minimum oxygen saturation and prolonging N1% are independent risk factors for MCI in this population.On the basis of oral antihypertensive drugs,after 3 months of regular CPAP treatment,the family measured systolic and diastolic blood pressure slightly decreased,and patients with MCI improved in visual space/executive function and delayed memory.CPAP has a positive significance in improving mild cognitive impairment in OSAS patients with hypertension.