失眠障碍患者慢波睡眠与执行功能的相关性研究OACSTPCD
Association between slow wave sleep and executive function in patients with insomnia disorder
目的 评估失眠障碍患者与正常睡眠者睡眠结构及执行功能差异,并探索失眠障碍患者执行功能障碍潜在机制.方法 纳入2022年3月—2023年12月就诊于重庆西区医院睡眠医学中心门诊的失眠障碍患者,并同期招募正常睡眠者为对照组.对所有受试者进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、多导睡眠监测、Stroop色词测验等评估,统计分析2组焦虑、抑郁、睡眠参数(入睡潜伏期、总睡眠时间、睡眠效率、NREM1期及其百分比、NREM 2期及其百分比、NREM 3期及其百分比、REM期及其百分比)、执行功能(Stroop A、Stroop B、Stroop C耗时间及正确数、干扰耗时数和干扰正确数)差异及其相关性.结果 失眠障碍组51例,对照组25例;失眠障碍组HAMA评分、HAMD评分、入睡潜伏期、NREM 1期百分比、NREM 2期百分比高于对照组,组间差异存在统计学意义(P<0.05);失眠障碍组总睡眠时间、睡眠效率、NREM 3期时间、REM期时间、NREM 3期百分比低于对照组,组间差异存在统计学意义(P<0.05);失眠障碍组Stroop色词测验C耗时数、干扰耗时数高于对照组,组间差异存在统计学意义(P<0.05);失眠障碍组Stroop C耗时数及干扰耗时数与NREM 3期时间、NREM 3期百分比呈负相关,且与NREM 2期时间、NREM 2期百分比呈正相关,Stroop C耗时数与NREM 1期百分比呈正相关(P<0.05).结论 失眠障碍患者存在入睡潜伏期长、总睡眠时间短、睡眠效率低、深睡眠减少和执行功能下降;执行功能下降与慢波睡眠减少相关.
Objective To investigate the differences in sleep structure and executive function between the patients with insomnia disorder and the individuals with normal sleep,as well as the potential mechanism of executive dysfunction in patients with insomnia disorder.Methods The patients with insomnia disorder who attended the outpatient service of Sleep Medicine Center,Chongqing Western Hospital,from March 2022 to December 2023 were enrolled as insomnia dis-order group,and the individuals with normal sleep were enrolled as control group.All subjects were evaluated using Ham-ilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),polysomnography,and Stroop Color-Word Test.The two groups were compared in terms of anxiety,depression,sleep parameters(sleep latency,total sleep time,sleep effi-ciency,NREM1 and its percentage,NREM2 and its percentage,NREM3 and its percentage,as well as REM and its per-centage),executive function(time consumption and correct number of Stroop A,Stroop B,Stroop C,and interference test),and a correlation analysis was also performed.Results There were 51 subjects in the insomnia disorder group and 25 subjects in the control group.Compared with the control group,the insomnia disorder group had significantly higher HAMA score,HAMD score,sleep latency,percentage of NREM1,and percentage of NREM2(P<0.05).Compared with the control group,the insomnia disorder group had significantly lower total sleep time,sleep efficiency,NREM3 duration,REM duration,and percentage of NREM3(P<0.05).Compared with the control group,the insomnia disorder group had significantly higher time consumption of Stroop Color-Word Test C and interference test(P<0.05).In the insomnia disor-der group,time consumption of Stroop C and interference test was negatively correlated with NREM3 duration and the per-centage of NREM3 and was positively correlated with NREM2 duration and the percentage of NREM2,and time consump-tion of Stroop C was positively correlated with the percentage of NREM1(P<0.05).Conclusion Patients with insomnia disorder tend to have a long sleep latency,a short total sleep time,low sleep efficiency,and reductions in deep sleep and executive function,and the reduction in executive function is associated with the reduction in slow-wave sleep.
叶圆圆;李文涛;陶敏;田倩;谢丽;文艳霞;冉艳琼;蒋晓江
上海中医药大学附属市中医医院脑病科,上海 200071重庆西区医院睡眠医学中心,重庆 400052
基础医学
失眠障碍执行功能多导睡眠监测慢波睡眠
Insomnia disorderExecutive functionPolysomnographySlow-wave sleep
《中风与神经疾病杂志》 2024 (003)
230-234 / 5
上海医学创新发展基金会项目"中西医结合卒中中心建设"(WL-CZZX-2022001K);2023年财政部及国家中医药管理局医疗服务与保障能力提升补助资金重点科室项目;上海市临床重点专科2024年医疗服务与保障能力提升补助资金项目
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