高觉醒阈值与阻塞性睡眠呼吸暂停患者持续注意力受损相关。
High arousal threshold is associated with impaired sustained attention in patients with obstructive sleep apnea.
文献信息
| PMID | 42843108 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Baixin Chen |
| 作者单位 | Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of the University of Manitoba Joint Laboratory of Biological Psychiatry, Shantou, Guangdong, China; Shantou Key Laboratory of Multimodal Mechanisms and Clinical Diagnosis and Treatment of Sleep Disorders, Shantou, Guangdong, China. |
| 期刊 | Heart & lung : the journal of critical care |
| SCI 分区 | Q2 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 阻塞性睡眠呼吸暂停（OSA）患者中持续注意力受损很常见，但其影响因素尚不清楚。高觉醒阈值（ArTH）的OSA患者常经历更严重的缺氧，可能加重持续注意力损害。
目的： 确定OSA中ArTH与持续注意力之间的关联。
方法： OSA定义为多导睡眠监测中呼吸暂停低通气指数（AHI）≥5次/小时。ArTH采用三项标准评分（每项1分）：1）AHI<30次/小时，2）最低外周血氧饱和度>82.5%，3）低通气比例>58.3%。高和低ArTH分别定义为0-1分和≥2分。持续注意力通过精神运动警觉任务（PVT）评估。持续注意力受损表现为更高的失误概率、更慢的平均1/反应时间（RT）、更慢的最慢10% 1/RT和更慢的最快10% 1/RT。
结果： 我们纳入97例OSA患者，其中59例高ArTH和38例低ArTH。在调整年龄、性别和超重后，高ArTH组表现出更高的失误概率（15.08±3.12 vs. 4.72±1.61%，p=0.004）、更低的最慢10% 1/RT（1.76±0.09 vs. 2.06±0.07 s-1，p=0.009）、平均1/RT（2.77±0.09 vs. 3.05±0.05 s-1，p=0.008）、最快10% 1/RT（3.64±0.10 vs. 3.86±0.06 s-1，p=0.068）。在额外调整教育水平和非快速眼动睡眠3期百分比后，这些结果仍相似。观察到较低ArTH评分与较高失误概率（趋势p=0.015）、较低最慢10% 1/RT（趋势p=0.009）、平均1/RT（趋势p=0.010）和最快10% 1/RT（趋势p=0.092）之间的线性趋势。
结论： 高ArTH可能与OSA患者持续注意力受损相关。评估ArTH可能有助于识别注意力损害高风险的OSA患者。
英文摘要
BACKGROUND: Impaired sustained attention is common in patients with obstructive sleep apnea (OSA), but the influencing factors are unclear. OSA patients with high Arousal threshold (ArTH) often experience severer hypoxia, possibly worsening sustained attention.
OBJECTIVES: To determine the association between ArTH and sustained attention in OSA.
METHODS: OSA was defined as apnea-hypopnea index (AHI) ≥5 events/hour in polysomnography. ArTH was scored using three criteria (1 point each): 1) AHI<30 events/hour, 2) minimum peripheral oxygen saturation >82.5%, and 3) hypopnea proportion >58.3%. High and low ArTH was defined as 0-1 and ≥2 points respectively. Sustained attention was evaluated by Psychomotor Vigilance Task (PVT). Impaired sustained attention manifested as higher lapse probability, slower mean 1/reaction time (RT), slower slowest 10% 1/RT, and slower fastest 10% 1/RT.
RESULTS: We included 97 OSA patients, with 59 high and 38 low ArTH patients. High ArTH group exhibited higher lapse probability (15.08±3.12 vs. 4.72±1.61%, p=0.004), lower slowest 10% 1/RT (1.76±0.09 vs. 2.06±0.07 s-1, p=0.009), mean 1/RT (2.77±0.09 vs. 3.05±0.05 s-1, p=0.008), fastest 10% 1/RT (3.64±0.10 vs. 3.86±0.06 s-1, p=0.068) with adjustment of age, gender, and overweight. These results remained similar after additionally adjusting education levels and percentages of non-rapid eye movement sleep stage 3. Linear trends were observed between lower ArTH scores and higher lapse probability (p-for-trend=0.015), lower slowest 10% 1/RT (p-for-trend=0.009), mean 1/RT (p-for-trend=0.010) and fastest 10% 1/RT (p-for-trend=0.092).
CONCLUSIONS: High ArTH may be associated with impaired sustained attention in OSA patients. Assessing ArTH may help identify OSA patients at high risk for attention impairment.