唤醒值改变了CPAP对阻塞性睡眠呼吸暂停患者执行功能的影响
Andrey V Zinchuk1, Clete A Kushida2, Alexander Walker3
1Department of Medicine, Yale University School of Medicine, New Haven, CT, USA andrey.zinchuk@yale.edu.
The European respiratory journal
|November 21, 2024
概括
在阻塞性睡眠呼吸暂停 (OSA) 患者中,更高的兴奋值 (ArTH) 与持续正气道压力 (CPAP) 治疗的更好的执行功能改善有关. 这表明ArTH可能预测OSA中的CPAP治疗反应.
科学领域:
- 睡眠医学 睡眠医学
- 神经科学是一个神经科学.
- 肺部病理学 肺部病理学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 经常与神经认知缺陷有关.
- 以前的随机试验并没有在没有痴呆症的OSA患者中从持续的正气道压力 (CPAP) 治疗中始终表明认知益处.
- 兴奋值 (ArTH) 在调节CPAP的神经认知效应中的作用仍然不清楚.
研究的目的:
- 调查ARTH是否影响CPAP治疗对OSA患者神经认知功能的有效性.
- 分析ARTH和CPAP治疗对执行功能,注意力和学习/记忆的相互作用.
主要方法:
- 随机,模拟控制的无呼吸正压长期疗效研究 (APPLES) 试验的二次分析.
- 兴奋值 (ArTH) 估计来自于多睡眠学数据.
- 神经认知结果包括执行功能的持续工作记忆测试-整体中午 (SWMT-OMD),注意力的Pathfinder Number测试和学习和记忆的Buschke选择性提醒测试.
- 在833名患有OSA的参与者中,通用线性建模评估了治疗×ARTH相互作用.
主要成果:
- 在执行功能方面观察到CPAP治疗和ARTH之间的显著相互作用 (p=0.042).
- 较高的ArTH与与假CPAP相比,在6个月内使用活性CPAP时,SWMT-OMD得分的更大改善有关.
- 对于ArTH每增加1个SD,SWMT-OMD得分提高了0.091.
- 没有发现ArTH对注意力 (p=0.311) 或学习和记忆 (p=0.744) 的显著影响修改.
结论:
- 在患有OSA的患者中,较高的兴奋值与CPAP治疗后执行功能的增强改善有关.
- 在OSA中,ArTH可以作为CPAP治疗对OSA执行认知功能的反应的预测生物标志物.
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