Differences of cognitive functions in the patients with different-subtype chronic insomnia disorder and correlations between cognition and objective sleep
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摘要: 目的 探索不同亚型慢性失眠障碍(chronic insomnia disorder,CID)患者认知功能有无差异及各亚型间认知功能与客观睡眠参数的相关性。 方法 收集2012年8月—2014年2月期间就诊于睡眠记忆障碍门诊的CID患者95例,根据患者主诉进行分型,包括入睡困难14例,早醒24例,维持困难24例,混合性33例。运用多导睡眠图评估患者一夜睡眠状况,次日采用蒙特利尔认知评估量表(MoCA)评估患者的认知功能,并完成匹兹堡睡眠质量指数量表(PSQI)及汉密尔顿抑郁量表(HAMD)测试。 结果 不同亚型CID患者注意(H=10.94,Ps<0.05)和延迟回忆(H=22.79,Ps<0.001)因子分差异性显著,即早醒组和混合组的相应因子分均显著低于入睡困难组和维持困难组(Ps<0.05)。所有患者的偏相关分析结果显示视空间与执行功能(r=0.245、0.219;Ps<0.05)及语言(r=0.234、0.222,Ps<0.05)因子分与N3持续时间和N3睡眠时间占总睡眠时间百分比正相关;注意因子分与N2持续时间及N2睡眠时间占总睡眠时间百分比正相关(r=0.209、0.364,Ps<0.05);延迟回忆因子分与N2持续时间和N2睡眠时间占总睡眠时间百分比(r=0.218、0.290,Ps<0.05)及N3持续时间和N3睡眠时间占总睡眠时间百分比(r=0.335、0.343,Ps<0.05)正相关。 结论 CID各亚型患者间认知功能水平存在差异性,其中视空间与执行功能、注意、延迟回忆等认知功能域与客观非快速动眼睡眠参数(NREM)有相关性。
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关键词:
- 失眠障碍 /
- 认知功能 /
- 蒙特利尔认知评估量表 /
- 多导睡眠图
Abstract: Objective To explore the differences of cognitive functions in the patients with chronic insomnia disorder(CID) in the different subtypes and the correlations between cognition and objective sleep parameters. Methods Ninety-five patients with CID were diagnosed in sleep and memory disorders outpatient clinic from August 2012 to February 2014.Then patients were divided into the group of patients with difficulty initiating sleep(14 patients),patients with early morning awakening(EMA,24 patients),patients with difficulty maintaining sleep(24 patients) and patients with mixed symptoms (MS,33 patients) in accordance with complaints.The sleep profile was measured using one-night polysomnogram.On the next morning,the sleep quality,cognitive function and depressive state were evaluated using Pittsburgh Sleep Quality Index(PSQI),Montreal Cognitive Assessment Scale(MoCA) and Hamilton Depression Scale(HAMD),respectively. Results The subscale scores of MoCA in the attention(H=10.94,Ps<0.05) and delayed recall(H=22.79,Ps<0.001)were significantly different among the 4 subtypes of patients,i.e.,the EMA and MS groups had lower scores compared to the other two groups (Ps<0.05).Moreover,the scores in the subscales of visual-spatial and executive function and language positively correlated with the N3 duration(r=0.245,0.219;Ps<0.05) and N3 in sleep period time (r=0.234,0.222;Ps<0.05);the scores in attention subscale positively correlated with the N2 duration and N2 in sleep period time(r=0.209,0.364,Ps<0.05);and the scores in delayed recall subscale positively correlated with the N2 duration and N2 in sleep period time(r=0.218,0.290;Ps<0.05),and N3 duration and N3 in sleep period time (r=0.335,0.343;Ps<0.05). Conclusion The cognitive functions had discrepancies among the patients with different subtypes of CID,and visual-spatial and executive function,attention subscale and delayed recall subscale might be associated with objective parameters of NREM sleep in the CID sufferers.-
Key words:
- Insomnia disorder /
- Cognition /
- MoCA /
- Polysomnogram
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