Research Of The Correlation Between Obstructive Sleep Apnea Hypopnea Syndrome And Cerebral White Matter Lesions

Background and purposeWhite matter lesions(WMLs)are one of the most common clinically diagnosed cerebral small vessel diseases(CSVD),which are associated with an increased risk of dementia and stroke.The features of WMLs in imaging include speckled or patchy white matter abnormalities in the paraventricular and subcortical areas.Obstructive sleep apnea hypopnea syndrome(OSAHS)is characterized by repeated obstruction of the upper respiratory tract during sleep,resulting in apnea and hypopnea accompanied by periodic drops in oxygen saturation and frequent awakenings.It leads to excessive daytime sleepiness,memory loss,autonomic nervous system dysfunction and other nervous system disorder,and increases the risk of cardiovascular and cerebrovascular diseases.Previous studies suggested that there might be a certain correlation between OSAHS and CSVD.Based on this,we speculated that WMLs,as one of the major types of CSVD,may also have a potential relationship with OSAHS.However,the evidence of the correlation between OSAHS and WMLs is limited,and there are still large gaps among the current research results in this regard.Therefore,this study aims to further explore the relationship between OSAHS and WMLs,confirm whether there is a correlation between the severity of WMLs and OSAHS,and analyze the related risk factors of WMLs.MethodsFrom June 2019 to December 2020,91 patients in the Department of Neurology,Epilepsy and Sleep Disorders of the Second Affiliated Hospital of Harbin Medical University were screened,who met the diagnostic criteria for WMLs.61 participants were selected for the control group without WMLs.Patients with chronic hypoxic disease,cerebral hemorrhage,atherosclerotic cerebral infarction,or white matter lesions caused by other reasons,and those who could not complete the relevant examination were excluded.All subjects underwent brain MRI examination,and were diagnosed by neurologists and radiologists.The severities of WMLs were graded according to the Fazekas scale.At the same time,patients received PSG examination,and the diagnosis of OSAHS and the severity grading were performed by sleep disorder specialists.Demographic data,previous history,personal history,laboratory and imaging examination results were collected.Statistical analysis was carried out using SPSS software.The count data is expressed as the percentage of the number of cases,and the measurement data is expressed as the mean ± standard deviation.The χ2 test and the T test are used for statistical analysis of the data.Spearman rank correlation method was used for correlation analysis of multiple classification variables.Logistic regression analysis was used for multivariate analysis.The difference between P<0.05 was statistically significant.ResultsThe incidence of OSAHS in the WMLs group was 92.3%,which was significantly higher than that of the control group(47.5%)(P<0.05).AHI of the patients in the WMLS group was 32.85±19.86 times/hour,which was significantly higher than that of the control group(12.12±18.26 times/hour).The minimum oxygen saturation was 74.60±12.08%,which was lower than that of the control group(81.04±12.37%)(P<0.05).The severity of WMLs and OSAHS was evaluated according to relevant standards,and Spearman rank correlation method was used to analyze the relationship between the severity of WMLs and OSAHS.The results showed that the severity of WMLs and OSAHS had a strong positive correlation(r=0.60252,P<0.05).There were statistically significant differences in age,gender,weight,BMI,diabetes,hypertension,homocysteine and OSAHS between the WMLs group and the control group(P<0.05).There was no significant difference in height,smoking,drinking and blood lipid between the two groups(P>0.05).It showed that age,gender,weight,BMI,diabetes,hypertension,homocysteine and OSAHS may be associated with WMLs.In order to exclude the interference of BMI and other factors on the incidence of OSAHS,all the above factors were further analyzed by multivariate Logistic regression,which showed that age(OR:1.077,95%CI:(1.023-1.134),P=0.005),BMI(OR:1.181,95%CI:(1.027-1.357),P=0.0196),OSAHS(OR:10.536,95%CI:(2.857-38.859),P=0.0004)were significantly correlated with WMLs.ConclusionsWMLs group was more prone to OSAHS than the control group.The severity of WMLs was positively correlated with the severity of OSAHS.Age,gender,body weight,BMI,diabetes mellitus,hypertension and homocysteine may be related risk factors for WMLs.Furthermore,age,BMI and OSAHS were significant risk factors for WMLs.In addition to age,an uncontrollable factor,early screening and intervention of OSAHS,long-term monitoring and BMI control should be emphasized to prevent and delay the occurrence and development of WMLs more effectively.