慢性失眠患者睡眠结构与记忆受损特点的研究

Characteristics of sleep architecture and memory impairment in patients with chronic insomnia

  • 摘要: 目的 探讨慢性失眠者记忆受损特点。 方法 采用匹茨堡睡眠质量指数量表和多导睡眠图评估31例慢性失眠患者(慢性失眠组)及29名健康体检者(对照组)的睡眠情况,并采用蒙特利尔认知评估量表和九盒迷宫测验评估2组认知和记忆功能,比较2组检测结果,并分析睡眠参数与记忆功能的相关性。 结果 2组的睡眠总时间、睡眠潜伏期、睡眠效率、睡眠觉醒时间均有差异(P均< 0.05)。与对照组比较,慢性失眠组慢波睡眠N1期占睡眠总时间的比例增多、N3期及快速眼球运动期占睡眠总时间的比例均减少(P均< 0.05)。慢性失眠组的物体工作记忆及空间工作记忆项目的错误数较对照组多(P均< 0.05)。相关性分析显示睡眠效率、快速眼球运动期占睡眠总时间的比例与工作记忆呈负相关,N2期占睡眠总时间的比例与工作记忆呈正相关(P均< 0.05)。 结论 慢性失眠患者存在空间工作记忆和物体工作记忆减退,可能与慢波睡眠各期占睡眠总时间比例的改变和快速眼球运动期占睡眠总时间比例减少有关。

     

    Abstract: Objective To investigate the characteristics of memory impairment in patients with chronic insomnia. Methods Chronic insomnia patients (chronic insomnia group) admitted to our hospital and healthy subjects (control group) receiving physical examination were selected to evaluate the sleep quality by using Pittsburgh Sleep Quality Index (PSQI) and the objective insomnia by polysomnography (PSG). The cognitive function was measured by Montreal Cognitive Assessment (MoCA). The memory function was assessed by nine-box maze test. The test results were statistically compared between two groups. The correlation between sleep parameters and memory function was analyzed. Results The total sleep time, sleep latency, sleep efficiency and sleep-wake cycle significantly differed between the chronic insomnia and control groups (all P < 0.05). Compared with the control group, the proportion of N1 was significantly increased, the proportion of N3 was remarkably decreased and the proportion of rapid eye movement (REM) was considerably decreased in the chronic insomnia group (all P < 0.05). The number of errors of object working memory and spatial working memory in the chronic insomnia group was significantly larger than that in the control group (both P<0.05). Correlation analysis demonstrated that sleep efficiency and the proportion of REM were negatively correlated with the working memory, whereas the proportion of N2 was positively correlated with the working memory (all P < 0.05). Conclusions Chronic insomnia patients have deteriorated spatial working memory and object working memory, probably correlated with the changes of the proportion of slow wave sleep and the decrease in the proportion of REM.

     

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