饥荒青蛙雨的预告:睡眠障碍性呼吸与认知障碍具有相关性

Elderly women suffering from sleep-disordered breathing have an increased risk of developing cognitive impairment or dementia, finds a new study published in the August 10 Journal of the American Medical Association.

一项发表在8月10日美国医学协会杂志上的研究发现，患有睡眠呼吸性障碍的老年妇女得认知障碍和痴呆症的风险更高。

The researchers noted that cognitive issues identified during the prospective study appear to be associated with hypoxia rather than with the quality and duration of sleep. 

研究人员指出，在前瞻性研究中被证明认知障碍的发生似乎是与缺氧有关，而与睡眠质量和时间无关。

“This study illustrates the importance of detecting breathing-related sleep disorders in older adults,” said Charles Reynolds III, M.D., chair of APA's DSM-V Sleep-Wake Disorders Work Group and a professor of psychiatry at the University of Pittsburgh. “We have also noticed that many older adults with depression and cognitive impairment often have a breathing-related sleep disorder, which, if treated appropriately, can help improve both cognition and mood.” 

“这项研究说明了研究呼吸性睡眠障碍对于老年人的重要性，”查理斯-雷诺兹三世说到，这位医学博士是美国精神科学会《精神疾病诊断与统计手册》睡眠障碍工作组的负责人、匹茨堡大学精神病学的教授。“我们也同样注意到许多患有抑郁症和认知障碍的老年人通常都有呼吸性睡眠障碍，如果能够治疗得当，这一发现有助于改善病人的认知和情绪。” 

For the study, a team of researchers led by Kristine Yaffe, M.D., of the University of California, San Francisco's departments of Psychiatry, Neurology, and Epidemiology collected baseline data from in-home, unattended polysomnography tests. The team's sleep and cognition study pooled participants from an existing multisite study of community-dwelling older women. 

关于此项研究，由美国加州大学医学博士、旧金山VA医学研究中心老年精神科主任克里斯汀·亚夫博士带领的研究团队，对来自各个家庭的自动化多频道睡眠记录测试基线数据进行了收集。该团队对睡眠和认知的研究对象主要来源于现居住于各个小区的老年妇女。

Over a period of approximately five years, the participants were given neuropsychological tests to assess their cognitive status. Ultimately, the researchers evaluated data collected on 298 women, more than 35 percent of whom were identified as suffering from sleep-disordered breathing. A majority of the participants (more than 90 percent) were white, and their mean age was 82.3. 

经过将近五年的时间，研究的参与者进行了神经心理学测试，从而评估她们的认知状况。最终，研究人员对来自298位妇女的数据进行了评估，她们当中超过35%的人被证明患有呼吸性睡眠障碍。大多数的参与者(超过90%)是白种人，她们的平均年龄是82.3岁。

While the baseline data revealed no significant difference in the cognitive functioning between the cohorts with and without existing sleep-disordered breathing, nearly 36 percent of the participants ended up developing either mild cognitive impairment or dementia. Approximately 45 percent of the women identified as having “prevalent sleep-disordered breathing” developed mild cognitive impairment or dementia compared with approximately 31 percent of those exhibiting normal nighttime breathing. 

尽管这些基线数据没有揭示出在认知功能方面患有睡眠呼吸性障碍者和未患者的重大差异，但是参与者中有36%左右的人最终要么是轻度认知障碍，要么是老年痴呆。 相对于那些31%左右睡眠呼吸正常的人而言，那些将近45%的患有普遍睡眠呼吸性障碍的妇女被证明更容易发展成轻度认知障碍和老年痴呆。 

Since the study findings demonstrated a consistent correlation between hypoxia measures and the subsequent development of cognitive impairment, the researchers suggested that further investigation of continuous positive air pressure (CPAP) treatment be undertaken. According to the researchers, earlier studies have shown CPAP to be effective in slowing or even improving the cognitive impairment of Alzheimer's patients with sleep-disordered breathing, as well as in improving the cognitive functioning of those suffering from sleep apnea. 

由于研究结果表明缺氧治疗和认知障碍的后续发展之间存在着一致相关性，研究人员建议进行进一步的持续性正压治疗的调查。据研究人员介绍，早期的研究已经显示出CAPA治疗方法对于延缓甚至改善因睡眠呼吸性障碍所引起的认知障碍是有效的，同时也较好地改善了睡眠呼吸暂停患者的认知功能。

Yaffe and her team recommended that further studies looking into the connection between sleep-disordered breathing and cognitive impairment should involve “larger sample sizes, longer treatment periods, and more diverse populations.”

亚夫博士和她的团队建议下一步进行睡眠呼吸性障碍和认知障碍相关性的调查应该“增大样本量、延长治疗期、针对更广泛的人群。”