慢性失眠患者睡眠结构与注意力、记忆的相关性

doi:10.6040/j.issn.1671-7554.0.2018.452

摘要/Abstract

摘要： 目的探讨慢性失眠患者的睡眠结构与注意力、记忆功能之间的关系。方法所有受试者均接受匹茨堡睡眠质量表(PSQI)、艾普沃斯量表(ESS)、失眠严重指数量表(ISI)的测评以及客观多导睡眠图(PSG)的监测,评估其睡眠质量及结构,据此分为慢性失眠组(n=31)和正常睡眠组(n=26);注意力功能的评估采用韦氏记忆量表中心智、视觉记忆广度和数字广度测试,记忆功能的评估采用韦氏记忆量表中长时记忆(经历、定向)和短时记忆(联想学习、逻辑记忆)等分项测验。结果与正常睡眠组相比,慢性失眠组PSQI、ESS和ISI评分增高,入睡潜伏期、非快速眼动睡眠所占比例(NREM1%)、非快速眼动睡眠2期所占比例(NREM2%)、入睡后觉醒时间及觉醒次数增多,而非快速眠动睡眠3期所占比例(NREM3%)减少,差异有统计学意义(P<0.05);慢性失眠组注意力功能降低主要表现在心智和视觉记忆广度测试,短时记忆减退表现在联想学习和逻辑记忆;通过多因素Logistic 回归分析,显示PSQI与心智、视觉记忆有关(P<0.05),NREM1%与联想记忆和逻辑记忆有关(P<0.05),NREM3%与逻辑记忆有关(P<0.01)。结论慢性失眠患者睡眠结构紊乱,注意力与短时记忆的损害主要与PSQI得分、NREM1%的增加以及NREM3%的减少相关。

关键词: 慢性失眠, 认知功能, 注意力, 记忆, 多导睡眠图

Abstract: Objective To explore the correlation between sleep architecture and attention and memory function in chronic insomniacs. Methods A total of 31 patients with chronic insomnia disorder and 26 good sleepers were enrolled in this study. All subjects were assessed with Pittsburgh Sleep Quality Index(PSQI), Epworth Sleepiness Scale(ESS), Insomnia Severity Index(ISI)and polysomnography(PSG)to evaluate sleep quality, the severity of insomnia and sleep architecture. Attention and memory functions were detected with the Wechsler Memory Scale(WMS). Results Compared with good sleepers, chronic insomniacs had higher scores of PSQI, ESS and ISI. They showed longer sleep latency, higher percentages of non-rapid eye movement sleep 1 stage(NREM1%)and non-rapid eye movement sleep 2 stage(NREM2%), and more times of wake after sleep onset(WASO), but lower percentage of non-rapid eye movement 山东大学学报 (医学版)57卷4期 -宋立敏,等.慢性失眠患者睡眠结构与注意力、记忆的相关性 \=-sleep 3 stage(NREM3%)(all P<0.05). In chronic insomniacs, the worsened attention could be seen from the intelligence test and visual memory span tests; the loss of short-time memory could be detected with associative learning and logical memory tasks. Multivariate Logistic regression analysis indicated that PSQI was correlated with intelligence and visual memory(P<0.05), NREM1% was correlated with associative learning and logical memory(P<0.05), and NREM3% was correlated with logical memory(P<0.01). Conclusion The sleep architecture is disordered in chronic insomniacs. The losses of attention and short-time memory are primarily correlated with PSQI score, increased NREM1% and decreased NREM3%.

Key words: Chronic insomnia disorder, Cognitive function, Attention, Memory, Polysomnography

中图分类号:

R741

宋立敏,鲁珊珊, 王大伟,吕鑫,高原,唐吉友. 慢性失眠患者睡眠结构与注意力、记忆的相关性[J]. 山东大学学报 (医学版), 2019, 57(4): 52-58.

SONG Limin, LU Shanshan, WANG Dawei, LÜ Xin, GAO Yuan, TANG Jiyou. Correlation between sleep architecture and attention and memory function in chronic insomniacs[J]. Journal of Shandong University (Health Sciences), 2019, 57(4): 52-58.

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