Study On The Oxygen Condition During Sleep In Alzheimer's Disease

Objective:Alzheimer's disease?AD?,most common type of dementia in the elderly,Characterized by memory impairment,aphasia,aphasia,apraxia,visual space impairment,personality and behavior change and so on.The appearance of senile plaques and neurofibrillary tangles in the brain and the loss of neurons are considered as the major pathological features of AD.Senile plaques also called neuritic plaques,Consists of amyloid beta,neurofibrillary tangles by abnormal hyperphosphorylation of tau protein accumulation.At present,the study shows that hypoxia is an important risk factor for the occurrence and development of AD,and the increase of A beta and tau protein phosphorylation.Polysomnography monitor can monitor the pulse oxygen saturation?SaO₂?,Apnea hypopnea index?AHI?,oxygen desaturation index?ODI?.The purpose of this study is the application of polysomnography monitor observation AD patients and healthy people sleep at night in hypoxia and sleep apnea,provide clues to further explore the relationship between chronic hypoxia and AD.Methods:Select 34 patients with AD of the Neurology department of the First Affiliated Hospital of Da Lian Medical Univercity and 28 age-and gender-matched control subjects.The clinical diagnostic criteria is in linewith DSM and NINCDS-ADRDA.All the subjects underwent a detailed clinical examination of the nervous system,and completed the Mini-Mental State Examination?MMSE?,the Montreal Cognitive Assessment?Mo CA?.All subjects underwent overnight polysomnography?monitoring time no less than 7 hours?,including: monitoring pulse oxygen saturation?SaO₂?,respiratory airflow,thoracoabdominal motion,snoring,posture and heart rate.After the automatic analysis of data by computer and acquire lowest oxygen saturation?LSaO₂?,mean oxygen saturation?MSaO₂?,AHI and ODI estimate whether there is sleep apnea hypopnea syndrome and night sleep hypoxaemia.According to the sleep apnea hypopnea syndrom diagnosis standard,on the basis of SAHS AHI values divided into mild?5?AHI < 15?,moderate?15?AHI < 30?,severe?AHI?30?.According to night sleep hypoxaemia ODI values divided into mild?5?ODI< 15?,moderate?15?ODI < 30?,severe?ODI?30?.SPSS13.0 software was used for statistical analysis of the data,the design of a significant level of alpha is 0.05,the use of independent sample t test and rank sum test to determine whether there was significant difference between the two groups.Result:1.There is no significant difference in age,gender,education level and BMI between the AD group and the control group.2.The average of MSaO₂ of AD is 94.56±1.64%,The mean of MSaO₂ in the control group is 96.75±0.93%,MSaO₂ in the AD group is lower than that in the control group?P =0.002?.3.The LSaO₂ is 84.50%?6%?in group AD,and the control group is?7%?.The LSaO₂ in AD group is lower than that in the normal control group?P =0.040?4.The AHI is 9.60?12.55?times per hour in group AD,and the control group is?3.75?times per hour,AHI in AD group is higher than that in control group?P=0.034?.AD group with SAHS 24 cases,including 15 mild cases,8 moderate cases and 1 severe cases;control group with SAHS 12 patients,including 10 mild cases,1 moderate cases and 0 severe cases,AD group of SAHS higher than the normal control group,there is significant difference?P=0.028?.5.The ODI is 3.95?5.50?times per hour in group AD,and the control group was?2.72?times per hour,there is no significant difference about ODI between the two groups?P=0.072?.In group AD,24 cases of nocturnal hypoxemia were found,of which there are mild in 15 cases,moderate in 8 cases,and severe in all cases in the control group.In the normal control group,there are 12 cases of nocturnal hypoxemia at night,of which there are mild in 10 cases,moderate in 1 cases,and severe in 0 cases.The nocturnal hypoxemia in group AD is higher than that in the control group?P=0.014?.6.There is no significant correlation between MSaO₂ and MMSE?P=0.129?,Mo CA?P=0.111?,duration of disease?P=0.439?in AD.There is no significant correlation between MSaO₂ and age?P=0.672?and BMI?P=0.122?in the control group.LSaO₂ is positively correlated with MMSE?P=0.010?and Mo CA?P=0.013?in AD,the lower the score,the lower the LSaO₂;There is no significant correlation between LSaO₂ and course of disease?P=0.422?in AD;There is no significant correlation between LSaO₂ and age?P=0.341?and BMI?P=0.418?in the control group.AHI and MMSE?P=0.001?,Mo CA?P=0.001?is significantly negatively correlated in AD,the lower the score,the greater the AHI;There is no significant correlation between AHI and course of disease?P=0.933?in AD;There is no significant correlation between AHI and age?P=0.803?and BMI?P=0.224?in the control group.There is no significant correlation between ODI and MMSE?P=0.154?,Mo CA?P=0.149?,duration of disease?P=0.988?in AD;There is no significant correlation between ODI and age?P=0.375?and BMI?P=0.919?in the control group.Conclusion:1.MSaO₂ and LSaO₂ are lower in AD than the normal group,nocturnal hypoxia is more common in patients with Alzheimer's disease.2.There is a higher incidence of SAHS in AD compared with the normal population.3.Nocturnal hypoxemia is more common in AD than the normal population.4.A positive correlation is found between LSaO₂ and MMSE and Mo CA in AD group,the more serious illness in AD,the LSaO₂ is lower;there is a negative correlation between AHI and the of MMSE and Mo CA in AD,the more serious illness in AD,the higher AHI.5.The LSaO₂,AHI has no significant correlation with the course,the MSaO₂,ODI and the of MMSE and Mo CA in AD;there is no significant correlation between MSaO₂, LSaO₂,ODI,AHI and BMI in the control group,there is no significant correlation between MSaO₂,LSaO₂,ODI,AHI and age in the control group.