Influence of continuous positive airway pressure on sleep status, neuropsychological characteristics in patients with stroke combined with obstructive sleep apnea syndrome
Notice bibliographique
Résumé
Objective To investigate the effects of continuous positive airway pressure (CPAP) on sleep status, neuropsychological characteristics in patients with stroke combined with obstructive sleep apnea syndrome (OSAHS). Methods Fifty-four patients hospitalized with stroke in Tianjin Medical University General Hospital from May 2014 to January 2016, who were with snoring and met the OSAHS diagnostic criteria, were randomly divided into CPAP combined with drug treatment group (25 cases) and drug treatment alone group (29 cases). The sleep structure and respiratory parameters were evaluated by polysomnography, and the changes of the patients′ sleep status was assessed by Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). The changes of neurocognitive function were assessed by Montreal Cognitive Assessment (MoCA), Digital Span Test (DST) and Hopkins Verbal Learning Test-revised (HVLT), and Patient Health Questionnaire-9 (PHQ9) was used to evaluate the depression mood changes. The changes of sleep status, cognitive function and mood in the CPAP combined with drug treatment group were compared before and three months after CPAP combined with drug treatment, and with the drug treatment alone group. Results Because five cases were dropped off, there were 20 patients in the CPAP combined with drug treatment group and 29 patients in the drug treatment alone group who completed the study. After three months of CPAP combined with drug treatment, the respiratory parameters apnea hypopnea index (AHI) in the CPAP combined with drug treatment group (29.32±16.57) was significantly lower than that before treatment (41.66±21.84; t=3.926, P=0.001), and the minimum blood oxygen saturation (LSaO2;82.11%±5.66%) was significantly higher than that before treatment (76.11%±8.90%; t=-5.054, P=0.000). However, the sleep structure parameters did not show statistically significant changes compared with those before treatment. The ESS, PSQI and PHQ9 scores in the CPAP combined with drug treatment group (4.53±3.86, 3.00±2.45, 0.00(0.00, 2.00))were significantly decreased compared with those before treatment (10.58±7.82, 7.53±2.87, 3.00(1.00, 9.00); t=-3.883, P=0.001; t=-6.522, P=0.000; Z=-3.549, P=0.000), whereas MoCA, HVLT (total scores, recall and recognition) and DST 1, 2 scores in the CPAP combined with drug treatment group (23.37±4.75, 22.32±6.90, 7.47±3.82, 7.84±2.59, 5.32±2.81) were increased compared with those before treatment (22.16±4.94, 19.16±7.66, 6.68±3.74, 7.32±2.67, 5.00±3.00; t=-2.773, P=0.013; t=-6.857, P=0.000; t=-2.704, P=0.015; t=-2.249, P=0.037; t=-2.882, P=0.010). The ESS, PSQI and PHQ9 scores were significantly reduced in the CPAP combined with drug treatment group compared with the drug treatment alone group (8.76±6.92, 7.59±5.49, 5.00(2.50, 9.50); t=-2.711, P=0.009; t=-3.941, P=0.000; Z=-4.555, P=0.000), whereas the DST1 score was significantly increased compared with the drug treatment alone group (6.45±1.43; t=2.144, P=0.042). Conclusions Three-month CPAP combined with drugs mainly improved the daytime sleepiness and depression of patients with stroke combined with OSAHS. Cognition especially in attention was significantly improved, and the degree of low ventilation and hypoxia was alleviated, whereas there was no significant change in sleep structure disorder. Key words: Stroke; Sleep apnea, obstructive; Cognition; Depression
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».