Study On The Characteristics And Correlation Of Sleepstructure And Cognitive Impairment In Patients With First-onset Depressive Disorder

Objectives:1.Research on first-episode depression disorder(Major depressive disorder,MDD)patients with sleep disorder.2.To explore the characteristics of cognitive impairment in MDD patients and its correlation with sleep characteristics3.The relationship between sleep structure and cognitive function in patients with first episode depression was analyzed.To investigate whether sleep structure is related to disease severity and cognitive function in patients with depressive disorder.Methods:In this study,77 patients with first-episode depression disorder who met the diagnostic criteria for depression disorders of the International Statistical Classification of Diseases and Related Health Problems(ICD-10)were included,and 40 patients with sleep disorders were collected as controls.Both groups underwent Polysomnography(PSG).The Hamilton depression rating scale(HAMD-24)was used to assess the severity of depression.The Montreal cognitive assessment(MoCA),Beijing version,was used as a measurement tool to assess the cognitive functions(visual space and executive ability,naming,memory,attention,language,abstraction,delayed recall,directional force).T test,Pearson correlation analysis,Logistic regression analysis were used to do data statistics by IBMSPSS25.0 software.Results:1.Comparison of sleep indicators between the depression disorder group and the sleep disorder group:n1%in the depression disorder group[9.300(5.300-15.500)]and the sleep disorder group[12.500(9.650-17.325)]showed a statistical difference(Z=-2.523,P<0.05).Compared two groups,the total sleep time(TST),sleep efficiency(SE),sleep latency(SL),the number of awakening(AT)incubation period,REM(RL),non rapid eye movement sleep phase 1 time(N1)and ratio(N1%),non rapid eye movement sleep stage 2 time(N2)and ratio(n%),non rapid eye movement sleep stage 3 time(N3)and scale(N3%)and rapid eye movement sleep time(RT)and ratio(REM%)had no statistical difference.There was no significant difference between the depressive disorder group and the sleep disorder group in demographic data.2.Compared with the group of normal cognitive function,the age of the patients with depression was 34.900±12.148 in the group with abnormal cognitive function and 23.500±5.105 in the group with normal cognitive function(T=-3.608,P<0.01).There was no significant difference between the two groups in gender,education level,BMI,PSQI,or the presence or absence of OSAHS(P>0.05).The arousal ratio was statistically significant in the normal cognitive function group of depression disorder[13.250(10.275-18.750)]and the abnormal cognitive function group[23.150(18.800-36.500)](T=-3.212,P<0.05).There was no significant difference in age,gender,education level,BMI,PSQI,OSAHS between the cognitive dysfunction group and the normal cognitive function group(P>,0.05).N3 time was statistically significant higher in the normal cognitive function group of sleep disorder[89.500(73.000-124.750)]than in the abnormal cognitive function group[48.500(37.500-65.875)](T=-2.582,P<0.05).The difference of N1 time and n1%between in the cognitive dysfunction group of depression disorder[7.700(5.300-14.900)]and the cognitive dysfunction group of sleep disorder[16.550(11.125-20.500)]was statistically significant(T=-2.810,P<0.05).There was no significant difference between the normal cognitive function group of depression disorder and the normal cognitive function group of sleep disorder.3.Comparison of cognitive function between the depression disorder group and the sleep disorder group:there was a statistical difference in the total MoCA score between the depression disorder group(23.233±4.091)and the sleep disorder group(20.080±5.737)(T=2.374,P<0.05).The apparent spatial and executive function factors were statistically different in the depression group(3.867±1.137)and the sleep disorder group(3.125±1.541)(T=2.035,P<0.05).The language factors in the sleep disorder group with OSAHS(1.550±0.688)were statistically different from the sleep disorder group without OSAHS(2.430±0.756)(T=-3.015,P=<0.05).4.Correlation between cognitive function and sleep structure in patients with depression disorder:in patients with depression disorder,the total MoCA score was negatively correlated with the arousal ratio(r=-0.503,P<0.05).The higher the arousal ratio was,the worse the cognitive function was.Directional function was positively correlated with sleep efficiency(r=0.540,P<0.05),and negatively correlated with arousal ratio(r=0.368,P<0.05).Delayed recall was negatively correlated with the number of awakenings(r=-0.462,P<0.05).Correlation between sleep structure and disease severity and factors of HAMD in depression group:In patients with depression,N2 time and HAMD(r=-0.231,P<0.05),cognitive impairment(r=-0.286,P<0.05)was negatively correlated;the arousal ratio was positively correlated with HAMD(r=0.266,P<0.05),block(r=0.269,P<0.05),cognitive impairment(r=0.230,P<0.05);N2%was Cognitive impairment(r=-0.272,P<0.05)was negatively correlated;REM latency was negatively correlated with anxiety/somatization(r=-0.233,P<0.05),systemic symptoms(r?-0.283,P<0.05);N1%was positively correlated with sleep disorders(r?0.279,P<0.05);sleep efficiency was negatively correlated with systemic symptoms(r=-0.276,P<0.05).Correlation analysis between cognitive function and various factors of HAMD in depression group:In patients with depression,attention was negatively correlated with body weight(r=-0.459,P<0.05);delayed recall was negatively correlated with sleep disorder(r=-0.474,P<0.05),which was negatively correlated with despair(r=-0.530,P<0.05).5.Correlation between cognitive function and sleep structure in patients with sleep disorders:in patients with sleep disorders,total MoCA score was negatively correlated with N2%(r=-0.480,P<0.05),and visual space and executive function were positively correlated with N3 time(r=0.452,P<0.05).Nominalization was positively correlated with REM latency(r=0.447,P<0.05),and negatively correlated with sleep efficiency(r=-0.405,P<0.05),N2%(r=-0.401,P<0.05),and N2 time(r=-0.532,P<0.05).Attention was positively correlated with the latency period of REM(r=0.405,P<0.05)and the number of waking times(r=0.426,P<0.05).Language was positively correlated with R%(r=0.406,P<0.05)and N3 time(r=0.480,P<0.05),but negatively correlated with arousal ratio(r=-0.400,P<0.05).Delayed recall was negatively correlated with N2 time(r=-0.442,P<0.05).Conclusion:1.N1%of MDD patients was lower than that of the sleep disorder group,and the time of light sleep was shortened.2.Compared with patients with sleep disorders,the impairment of cognitive functions such as visual spatial function and executive function in MDD patients is relatively minor,and the impairment of cognitive function of MDD may be related to the increase of age and wakefulness ratio.The cognitive impairment in patients with sleep disorders is related to the decrease of OSAHS and N3.3.The cognitive dysfunction and sleep disorder of MDD patients influence and correlate with each other.The cognitive impairment of MDD patients is related to the sleep process,and the sleep process is mainly related to the sleep maintenance disorder(that is,the increase of waking times,the increase of awakening ratio,etc.)and the decrease of sleep efficiency.The more severe the depressive symptoms in patients with depressive disorders,sleep maintenance disorders(increased wake ratio),shortened REM latency,increased light sleep time,and lower sleep efficiency;the more obvious the depressive symptoms in depressive patients,the more severe the cognitive impairment.The cognitive dysfunction of patients with sleep disorder is related to the disorder of sleep structure,which is mainly related to the deprivation of slow wave sleep and REM sleep.