Abstract
OBJECTIVE To explore the differences in sleep structure parameters and their correlation with cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)with different body mass index(BMI).METHODS 150 OSAHS patients admitted to Baoding First Central Hospital from June 2021 to June 2024 were selected as the research subjects.They were divided into cognitive impairment group(n=48)and non cognitive impairment group(n=102)based on based on whether cognitive impairment occurred.Then,there were 31 cases in the normal group(18.5 kg/m2≤BMI<24 kg/m2),67 cases in the overweight group(24 kg/m2≤BMI<28 kg/m2),and 52 cases in the obese group(≥28 kg/m2)according to BMI levels.We compared the clinical data,BMI levels,and changes in sleep structure parameters between two groups of patients;We used multiple logistic regression to analyze the influencing factors of cognitive impairment in patients;We used two factor analysis of variance to compare the effects of different BMI and sleep structure on cognitive function scores;We drawed a restrictive cubic spline analysis to investigate the nonlinear correlation between sleep structure parameters and cognitive impairment;We constructed a mediation effect model to analyze the impact of sleep structure on BMI and cognitive impairment.RESULTS The percentage of total sleep time spent with oxygen saturation below 90%(TS90%),sleep latency(SL),and microarousal index(MAI)of the overweight group were significantly higher than those of the normal group,while total sleep time(TST),sleep efficiency(SE),rapideyemovement(REM)and montreal cognitive assessment(MoCA)total score were significantly lower than those of the normal group.Moreover,the changes in these indicators were significantly greater in the obese group than in the overweight group(P<0.05);There were statistically significant differences in age,BMI,years of education,pittsburgh sleep quality index(PSQI)score,apnea hypopnea index(AHI),obstructive apneaindex(OAI),lowest oxygen saturation(LSaO2),oxygen depletion index,TST,TS90%,SE,REM,SL,MAI,and MoCA total score between cognitive impairment group and non-cognitive impairment group(P<0.05);The results of the multiple logistic regression model analysis showed that age,BMI,AHI,oxygen depletion index,TS90%,SL,and MAI were independent risk factors for cognitive impairment in OSAHS patients,while education level,LSaO2,TST,REM,and SE were protective factors(all P<0.05);The results of the two factor analysis of variance showed that regardless of the patient's PSQI score,there was a statistically significant difference in MoCA scores between different BMI groups(F=8.569,P<0.001);The results of the restricted cubic spline analysis showed a significant positive correlation between TS90%,SL,MAI levels and cognitive impairment,while TST,SE,REM levels showed a significant negative correlation(P<0.05);The results of the mediation effect model analysis showed that sleep structure played a mediating role between BMI and cognitive impairment(P<0.001).CONCLUSION As BMI increases,cognitive function declines in OSAHS patients.Clinically,by controlling body weight and monitoring sleep structure parameters,early diagnosis and treatment can be achieved to reduce the risk of cognitive impairment in OSAHS patients and effectively improve their quality of life.关键词
睡眠呼吸暂停,阻塞性/肥胖/睡眠结构/认知损害/相关性Key words
Sleep Apnea,Obstructive/Obesity/sleep structure/cognitive impairment/correlation
