Büşra Durak, Duygu Özol, İbrahim Durak, Sema Saraç
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引用次数: 0
Abstract
Background: Obstructive sleep apnea syndrome (OSAS) is a condition defined by recurrent episodes of airflow cessation or significant reduction during sleep, resulting in fragmented sleep patterns and intermittent hypoxemia. These physiological disturbances are known to contribute to cognitive deficits, including impairments in attention, memory, and overall cognitive function. In parallel, amyloid beta (β-Amyloid, Aβ) has gained prominence as a crucial biomarker in Alzheimer's disease pathogenesis, raising interest in its potential role in the early detection of neurocognitive dysfunction. This study aims to explore the association between plasma Aβ levels, neurocognitive performance, and polysomnographic parameters in middle-aged patients diagnosed with OSAS.
Methods: This prospective, cross-sectional study was conducted over a four-month period in a sleep disorders clinic. Patients who diagnosed as OSA in polysomnographic evaluation with no pre-existing neurocognitive conditions and possessed at least a primary school education were included. The study participants were evaluated using Montreal Cognitive Assessment (MoCA) test and Epworth Sleepiness Scale (ESS). Morning fasting blood samples were collected to measure plasma total Aβ levels.
Results: A total of 126 individuals (mean age: 54.7 ± 7.5 years; 53 females, 42%) participated in the study. Based on their apnea-hypopnea index (AHI), patients were categorized into two groups: Group 1 (AHI < 15, 23.8% mild OSA) and Group 2 (AHI ≥ 15, moderate-severe OSA, 76.2%). The mean MoCA scores were 25 ± 7 in Group 1 and 24 ± 6 in Group 2. Following multivariable adjustment, reduced sleep duration, lower mean nocturnal oxygen saturation, and prolonged time with SpO2 below 90% (T90%) were significantly correlated with lower MoCA scores. Serum Aβ concentrations were notably elevated in patients with severe OSAS, exhibiting a negative correlation with MoCA scores and slow wave sleep stage. Additionally, serum Aβ levels showed a direct correlation with both AHI and oxygen desaturation index (ODI), while an inverse correlation was found with minimum oxygen saturation.
Conclusion: Neurocognitive impairment was common in OSAS patients. Elevated serum Aβ levels were found to be directly associated with OSA severity, and OSA-related hypoxemia was linked to diminished cognitive function.
背景：阻塞性睡眠呼吸暂停综合征（OSAS）是一种由睡眠期间反复发作的气流停止或明显减少所定义的疾病，导致睡眠模式碎片化和间歇性低氧血症。众所周知，这些生理障碍会导致认知缺陷，包括注意力、记忆力和整体认知功能的损害。与此同时，β-淀粉样蛋白（β-Amyloid, a β）作为阿尔茨海默病发病机制中的重要生物标志物已得到重视，其在早期检测神经认知功能障碍中的潜在作用引起了人们的兴趣。本研究旨在探讨中年OSAS患者血浆Aβ水平、神经认知能力和多导睡眠图参数之间的关系。方法：这项前瞻性横断面研究在一家睡眠障碍诊所进行了为期4个月的研究。在多导睡眠图评估中诊断为OSA的患者没有预先存在的神经认知疾病，并且至少具有小学教育程度。采用蒙特利尔认知评估（MoCA）和爱普沃斯嗜睡量表（ESS）对研究对象进行评估。采集空腹晨血，测定血浆总Aβ水平。结果：共126例患者，平均年龄54.7±7.5岁；53名女性（42%）参与了这项研究。根据患者的呼吸暂停低通气指数（AHI）将患者分为两组：1组（AHI）结论：OSAS患者普遍存在神经认知障碍。血清Aβ水平升高与OSA严重程度直接相关，OSA相关的低氧血症与认知功能下降有关。
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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