{"title":"The association between hypoxic burden and the risk of cognitive impairment in patients with obstructive sleep apnea.","authors":"Xiaoyu Huang, Zhengjiao Zhang, Xiaoxin Lan, Xuefeng Song, Yanzhao Dong, Siqi Jia, Haibo Yuan","doi":"10.1093/sleep/zsae269","DOIUrl":null,"url":null,"abstract":"<p><strong>Study objectives: </strong>Obstructive sleep apnea (OSA) is associated with increasing risk of cognitive impairment, but traditional hypoxic indicators can not accurately identify cognitive impairment. This study aimed to assess a new indicator, hypoxic burden, in cognitive impairment in OSA.</p><p><strong>Methods: </strong>A total of 116 patients with OSA were enrolled in this study. Daytime sleepiness and cognition were assessed by Epworth Sleepiness Scales (ESS) and Montreal Cognitive Assessment (MoCA), respectively. All participants underwent polysomnography. Hypoxic burden was derived from polysomnography and calculated according to a specific algorithm. All the subjects were divided into two groups. 77 were OSA with mild cognitive impairment (OSA+MCI) and 39 were OSA without mild cognitive impairment (OSA-MCI). The relationship between hypoxic burden and cognitive impairment was analyzed by establishing a series of logistic regression models.</p><p><strong>Results: </strong>Hypoxic burden was higher in OSA+MCI group compared with OSA-MCI group, while there was no significance found for the apnea-hypopnea index (AHI) between the two groups. After adjusting for various confounders, patients with OSA who had a higher total hypoxic burden and REM-hypoxic burden in the fourth quartile were found to have an increased risk of MCI compared to those in the first quartile. The adjusted ORs were 7.69 (95%CI 1.15-51.55) and 8.87 (95%CI 1.22-64.34), respectively. However, There was no significant association between the other traditional hypoxic parameters and cognitive function after adjusting for various confounders.</p><p><strong>Conclusion: </strong>Compared to the conventional hypoxic parameter, higher hypoxic burden is associated with cognition and may be an important indicator for assessing MCI in OSA.</p>","PeriodicalId":22018,"journal":{"name":"Sleep","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/sleep/zsae269","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
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Abstract
Study objectives: Obstructive sleep apnea (OSA) is associated with increasing risk of cognitive impairment, but traditional hypoxic indicators can not accurately identify cognitive impairment. This study aimed to assess a new indicator, hypoxic burden, in cognitive impairment in OSA.
Methods: A total of 116 patients with OSA were enrolled in this study. Daytime sleepiness and cognition were assessed by Epworth Sleepiness Scales (ESS) and Montreal Cognitive Assessment (MoCA), respectively. All participants underwent polysomnography. Hypoxic burden was derived from polysomnography and calculated according to a specific algorithm. All the subjects were divided into two groups. 77 were OSA with mild cognitive impairment (OSA+MCI) and 39 were OSA without mild cognitive impairment (OSA-MCI). The relationship between hypoxic burden and cognitive impairment was analyzed by establishing a series of logistic regression models.
Results: Hypoxic burden was higher in OSA+MCI group compared with OSA-MCI group, while there was no significance found for the apnea-hypopnea index (AHI) between the two groups. After adjusting for various confounders, patients with OSA who had a higher total hypoxic burden and REM-hypoxic burden in the fourth quartile were found to have an increased risk of MCI compared to those in the first quartile. The adjusted ORs were 7.69 (95%CI 1.15-51.55) and 8.87 (95%CI 1.22-64.34), respectively. However, There was no significant association between the other traditional hypoxic parameters and cognitive function after adjusting for various confounders.
Conclusion: Compared to the conventional hypoxic parameter, higher hypoxic burden is associated with cognition and may be an important indicator for assessing MCI in OSA.
研究目的：阻塞性睡眠呼吸暂停（OSA）与认知障碍的风险增加有关，但传统的缺氧指标无法准确识别认知障碍。本研究旨在评估一种新的指标--缺氧负担对 OSA 认知功能障碍的影响：方法：本研究共纳入了 116 名 OSA 患者。方法：共招募了116名OSA患者，分别采用埃普沃斯嗜睡量表（ESS）和蒙特利尔认知评估（MoCA）对其白天嗜睡和认知能力进行评估。所有参与者都接受了多导睡眠图检查。缺氧负荷由多导睡眠图得出，并根据特定算法进行计算。所有受试者被分为两组。77例为伴有轻度认知障碍的OSA（OSA+MCI），39例为无轻度认知障碍的OSA（OSA-MCI）。通过建立一系列逻辑回归模型，分析了缺氧负荷与认知障碍之间的关系：结果：与 OSA-MCI 组相比，OSA+MCI 组的低氧负荷更高，而两组之间的呼吸暂停-低通气指数（AHI）没有显著性差异。在对各种混杂因素进行调整后，发现总缺氧负荷和快速眼动缺氧负荷较高的第四四分位数的OSA患者与第一四分位数的患者相比，罹患MCI的风险更高。调整后的OR值分别为7.69（95%CI 1.15-51.55）和8.87（95%CI 1.22-64.34）。然而，在调整了各种混杂因素后，其他传统缺氧参数与认知功能之间并无明显关联：结论：与传统缺氧参数相比，较高的缺氧负荷与认知功能相关，可能是评估 OSA MCI 的重要指标。
期刊介绍：
SLEEP® publishes findings from studies conducted at any level of analysis, including:
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