The Characteristics Of Attention And Short-term Memory Impairment In Young Patients With Obstructive Sleep Apnea-hypopnea Syndrome And Analysis Of Influencing Factors

Objective:To explore the characteristics and influencing factors of attention and short-term memory impairment in young patients with obstructive sleep apnea-hypopnea syndrome?OSAHS?.Methods:A total of 203 eligible patients with snoring were screened for the study at Sleep Center,Second Affiliated Hospital,Soochow University from July 2016 to July 2017,they were all monitored with overnight polysomnography?PSG?,and sleep parameters?light sleep ratio,deep sleep ratio,REM sleep ratio?and respiratory parameters?AHI,ODI,LSaO2,TS90%,RRMAI?were recorded.Based on apnea/hypopnea index?AHI?,the patients were categorized into non-OSAHS groups?0/h<AHI?5/h??mild and moderate OSAHS groups?5/h<AHI?30/h??Severe OSAHS groups?AHI>30/h?.All patients were assessed for sleepiness and neurocognitive scales,including the Motreal Cognitive Assessment?MoCA?questionnaires,Mini-mental State Examination?MMSE?,Epworth Sleepiness Scale?ESS?,attention and short-term memory assessment which include Trail Marking Test?TMT?,digit span test?DST?,and Complex Figure Test?CFT?.PSG parameters,ESS scores,total MoCA scores,Attention and short-term memory were compared among groups,and a correlation analysis was conducted to investigate the characteristics of attention and short-term memory impairment in OSAHS patients and their influencing factors.Results:1.Comparison of general data and PSG parameters in the three groups of patients:There was no statistical difference in the age,education level,morbidity of hypertension and diabetes among the three groups of patients;With the increase of the severity of OSAHS,the proportion of male patients,the proportion of daytime sleepiness,BMI,and ESS all increased significantly.Compared with the other two groups,ODI,RRMAI,I+II phase ratio,and TS90%of patients with severe OSAHS were significantly increased,and the III phase ratio and LSaO₂ were significantly decreased;2.Comparison of cognitive function scores in the three groups:Compared with the other two groups,severe OSAHS patients' s MoCA scores decreased?P<0.01?,and ESS scores increased obviously?P<0.01?,but MMSE scores had no difference;3.Comparison of attention and short-term memory performance in three groups of patients:In the Digit Span Test,scores on the DST-D?8.1±1.1vs 8.5±1.0?8.8±0.9?and DST-B?5.5?4.0,7.0?vs 6.0?5.0,7.0??6.0?5.0,7.0??were significantly lower than those in the other two groups?P<0.01?.In assessing visual memory,the re-drawing scores?5.5?4.0,7.0?vs 6.0?5.0,7.0?,6.0?5.0,7.0??were significantly lower than the other two groups?P<0.01?,and there were no significant difference between 3 groups of copy scores of CFT.In the execution function test,the use time of TMT-A?46.7±19.0 vs 40.2±17.4?34.6±17.2?and TMT-B?76.9±32.6vs 67.2±21.2,58.6±27.5?were significantly higher than the other two groups?P<0.01?,and the number of errors occurred no significant difference between the 3 groups;4.Analysis of the influence factors of attention and short-term memory:Sperson correlation analysis,DST-D?TMT-A?CFT performance of OSAHS patients were negatively correlated with the BMI,AHI,ODI,and phase I+II ratios,and positively correlated with TS90%and phase III ratio.DST-B?TMT-B performance of OSAHS patients were negatively correlated with the BMI,AHI,ODI,and phase I+II ratios,and positively correlated with TS90%and phase III ratio.With similar BMI and sex ratio,Partial correlation analysis,DST?TMT and CFT performance of OSAHS patients were negatively correlated with the AHI,ODI,and phase I+II ratios,and positively correlated with TS90%and phase III ratio;Further Multivariate Logistic Stepwise Regression Analysis showed that,AHI,ODI and phase I+II ratios were Influencing factors.Conclusion:The cognitive function of young-aged OASHS patients was impaired,especially in terms of attention and short-term memory function.The severity of apnea and hypoxia,I+II ratio were all influencing factors.