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fragmentation. It has a close relationship with cognitive function. Objective To explore the relationship of cognitive function
with emotion and sleep architecture in patients with OSAHS. Methods A retrospective analysis was conducted. Participants
were 116 cases of OSAHS diagnosed by polysomnography（PSG） recruited from Sleep Medical Center，Shengjing Hospital of
China Medical University from September 2019 to December 2020. Clinical data were collected，including results of PSG and
questionnaires before PSG〔including Generalized Anxiety Disorder（GAD-7），Patient Health Questionnaire-9（PHQ-9），
Montreal Cognitive Assessment（MoCA），Mean Memory and Executive Screening（MES），Insomnia Severity Index（ISI），
Epworth Sleepiness Scale（ESS）〕. According to the total score of MoCA，participants were divided into normal cognition group
（≥ 26 points， n=79） and abnormal cognition group （<26 points， n=37）. Pearson and Spearman correlation analyses were
used to study the correlation of cognitive function with PSG indicators. Multiple linear regression analysisi was used to explore the
factors associated with cognitive function. Results There were no significant differences in emotion functions between normal
cognition group and abnormal cognition group. Both groups had significant differences in mean age，sex ratio，MES score，total
arousals，arousals in non-rapid eye movement（NREM），arousals in rapid eye movement（REM），total sleep time（TST），
wake after sleep onset（WASO），sleep efficiency，percentage of stage N3 sleep（N3/TST%） and percentage of REM（REM/
TST%） （P<0.05）. Correlation analyses showed that MoCA score was negatively correlated with age，apnea hypopnea index
（AHI），and WASO（P<0.05），and positively correlated with TST，sleep efficiency，REM/TST%，total arousals and
arousals in REM（P<0.05）. The score of delayed recall in the MoCA scale was negatively correlated with age and WASO
（P<0.05），and positively correlated with sleep efficiency，REM/TST%，total arousals and arousals in REM（P<0.05）.The
total score of MES was negatively correlated with age（P<0.05），and positively correlated with REM/TST%，total arousals，
and arousals in NREM and REM（P<0.05）. Multiple linear regression analysis showed that age，AHI and REM/TST% were
associated with MoCA score（P<0.05），and age was associated with delayed recall score and MES score（P<0.05）. The final
regression model established using stepwise regression revealed that the MoCA score had a stronger correlation with age and REM/
TST%，and MoCA score was negatively correlated with age（P<0.05），and positively correlated with REM/TST%（P<0.05）.
Conclusion The decline of cognitive function in OSAHS patients was significantly correlated with the reduction of REM. No
obvious abnormality in emotion was found in these patients with cognitive dysfunction. The relationship between cognitive function
and sleep architecture in OSAHS patients can be further clarified in future research.
【Key words】 Sleep apnea，obstructive；Cognitive function；Emotion；Sleep architecture；Root cause analysis

睡眠障碍是现代人普遍存在的现象，这与科技发展
本研究价值及局限性：
后生活习惯改变息息相关。阻塞性睡眠呼吸暂停低通气
（1）本研究通过多种量表评估阻塞性睡眠呼吸
综合征（OSAHS）是一种常见睡眠障碍疾病，其发病机
暂停低通气综合征（OSAHS）患者认知功能，使用多
制是睡眠中上呼吸道反复塌陷、阻塞而发生呼吸暂停和
种情绪自评量表反映患者情绪状况，将 OSAHS 与认
低通气，并出现间歇性低氧血症、高碳酸血症以及睡眠 知功能、情绪三者相结合，同时对 OSAHS 患者的多
结构紊乱 ［1］ 。一直以来 OSAHS 与认知障碍均是研究的
导睡眠检测（PSG）数据进行全面分析，发现其与认
热点问题，OSAHS 患者的认知功能损害大多表现在记 知和情绪的关联。（2）着重于 PSG 中睡眠结构相关
忆力、注意力、执行力和视空间方面 ［2］ 。记忆巩固能
数据，除年龄、呼吸暂停低通气指数（AHI）等因素
力与睡眠过程中大脑活动密切相关，OSAHS 导致的睡 的影响外，还发现睡眠分期中快眼动睡眠（REM）期
眠片段化影响了睡眠依赖的记忆巩固 ［3］ ，通过对脑电
与认知功能的相关性。为进一步研究 REM 期对人类
活动的研究，人们发现快眼动睡眠（REM）有助于程序 大脑的生理影响提供了一定参考依据。本研究局限性
性记忆巩固 ［4］ ，而由于 REM 期上呼吸道生理变化，控
在于对情绪的评估和认知功能的测定均来自量表，其
制咽部肌肉舒张的肾上腺素能和 5- 羟色胺能神经活动 结果具有主观性，易出现误差。未来可进一步通过一
下降，使上呼吸道塌陷倾向增加 ［5］ ，REM 期更容易出
些认知功能测定程序等客观数据，并结合脑成像技术
现呼吸暂停，因此 OSAHS 对 REM 期神经生理活动的影
分析 OSAHS 对人类大脑结构及功能的影响。
响不能忽视，OSAHS 患者的认知记忆改变与睡眠结构
的相关性是研究的重点。 相关文献的综述中显示，OSAHS 患者抑郁的患病率为
此外，抑郁，焦虑等情绪问题也常在 OSAHS 患者 7%~63%，焦虑的患病率 11%~70% ［6］ 。躯体疾病和情
中发生。OSAHS 患者在经过整夜睡眠后仍会出现日间 绪问题并存对于患者的认知功能是双重考验，相较于
睡，严重影响日间活动，长期如此则会导致患者的心 未合并抑郁症状的 OSAHS 患者，合并抑郁症状增加了
理状态发生改变。在一篇分析了 1995—2006 年 55 篇 神经损伤 ［7］ 。本研究目的是探索 OSAHS 患者认知功能