Study On The Effects Of Anxiety And Depression On Cognitive Function In Patients With Insomnia

Objective:To investigate the incidence of anxiety and depression in insomniacs,to clarify the differences in subjective and objective sleep parameters and different cognitive load tasks in patients with accompanied and unaccompanied anxiety and depression,to explore the relationship between anxiety and depression,subjective and objective sleep and cognitive function in insomniacs,and to provide the basis for clinical diagnosis and treatment.Method:In the course of outpatient diagnosis and treatment,the basic data of age,sex and education of insomnia patients were collected,the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the anxiety and depression status of insomnia patients,which were divided into No anxiety depression Group and anxiety-depression group,Pittsburgh sleep quality index scale(PSQI)and Acti Graph(ACT)to evaluate the subjective and objective sleep status of insomnia patients,and to evaluate the cognitive function level of insomnia patients by using the Integrated Visual and Auditory Continuous Performance Test(IVA-CPT)and Raven's Progressive Matrices(RPM).Result:1.Differences in subjective and objective sleep between two groups(1)Differences in subjective sleep scores between two groupsThere were significant differences in PSQI total sleep time and daytime dysfunction factor score between two groups(P <0.05),while there were no significant differences in other factors.(2)Differences in objective sleep parameters between the two groupsThere was no significant difference in actigraph sleep parameters between two groups(P>0.05).2.Differences in cognitive function scores between two groups(1)Difference in IVA-CPT scores between the two groupsThere were significant differences in IVA-CPT comprehensive attention,visual attention,auditory attention(P<0.05),and no significant differences in comprehensive control,visual control and auditory control(P>0.05).(2)Differences in Raven's Reasoning test scores between two groupsThere were significant differences between two groups in the similarity comparison ability of raven's reasoning test,comparative reasoning ability,abstract reasoning ability(P<0.05),and no significant differences in the total perceptual discrimination ability of reasoning ability(P>0.05).3 Correlation analysis between subjective and objective sleep and cognitive function(1)Correlation analysis between subjective sleep and cognitive functionThere were significant correlation between reasoning ability and PSQI sleep efficiency(r=-0.171,P<0.05).There were significant correlation between comprehensive control ability and sleep time(r=0.217,P<0.01).Comprehensive attention was significantly associated with daytime dysfunction(r=-0.204,P<0.05)(2)Correlation analysis betwee objective sleep and cognitive functionThere was a significant correlation between reasoning ability and sleep latency of actigraph(r =-0.153,P<0.05).There was a significant correlation between and sleep latency on the somatometer(r =-0.146,P<0.05).Comprehensive attention was significantly associated with sleep latency(r=-0.217,P<0.01)and sleep efficiency(r=0.247,P<0.01).4 Correlation analysis of SAS,SDS and cognitive function(1)Correlation analysis of SAS,SDS and IVA-CPTSAS was significantly correlated with comprehensive attention(r=-0.237,P <0.01).SDS was significantly associated with comprehensive attention(r=-0.296,P <0.01).(2)Correlation analysis of SAS,SDS and Raven's Reasoning test scoresSAS was significantly correlated with reasoning ability(r =-0.230,P <0.01).SDS was significantly associated with reasoning ability(r =-0.302,P<0.01).5 Correlation analysis of SAS,SDS and subjective and objective sleep parameters(1)Correlation analysis of SAS,SDS and subjective sleepSAS was significantly correlated with PSQI score(r= 0.290,P <0.01),sleep quality(r=0.185,P <0.05),time to sleep(r=0.167,P<0.05),and daytime dysfunction(r=0.352,P <0.01).SDS was significantly correlated with factor scores of PSQI total score(r=0.224,P<0.01)and sleep quality(r=0.143,P <0.05).(2)Correlation analysis of SAS,SDS and objective sleepSAS was significantly correlated with objective sleep parameters.SDS was significantly correlated with somatometer sleep latency(r =0.156,P<0.05).6.Stepwise multiple regression analysis of subjective and objective sleep,SAS and SDS on cognitive functionSDS(Beta=-0.295,P<0.01)and Pittsburgh Sleep Index(Beta=0.171,P<0.05)and sleep disorder factor(Beta=-0.164,P <0.05)were the main factors affecting the reasoning ability of patients with insomnia;The time to sleep of Pittsburgh Sleep Index(Beta=-0.217,P<0.01)was the main factor affectingthe comprehensive control of insomnia patients;SDS(Beta=-0.299,P <0.01),actigraph sleep efficiency(Beta=0.254,P <0.01),Pittsburgh Sleep Index scale sleep disorder factor(Beta=-0.150,P<0.05)were the main factors affecting the comprehensive attention of insomnia patients.Conclusion:(1)Insomniacs with depression had more severe impairment in cognitive function;(2)Impairment of sustained attention may be the main feature of cognitive impairment associated with anxiety,depression and insomnia;(3)The more severe the depression,the lower the subjective and objective sleep efficiency,the longer the subjective sleep time,and the more influential factors of sleep disorder,the more serious the cognitive impairment of insomnia patients will be.