ارزيابي عملكرد عصبي – رفتاري در مبتلايان به سندرم آپنه انسدادي خواب مراجعه كننده به كلينيك خواب بيمارستان بهارلو در سال 1394


۴ مهر ۱۳۹۶

اختلالات تنفسی و به خصوص خروپف از مشکلات شایع در حین خواب هستند. آپنه انسدادی در حین خواب منجر به اختلالات عصبی رفتاری ناشی از هیپوکسی، افزایش فعالیت سمپاتیک و افزایش تعریق شبانه میشود که به صورت کاهش حافظه و اختلال در عملکردهای شناختی و توجه می شود. با توجه به اهمیت این موضوع، مطالعه ی حاضر جهت ارزیابی اختلالات عصبی رفتاری در افراد مبتلا به آپنه انسدادی خواب انجام شد.

روش کار: در این مطالعه ی مقطعی 65 نفر از مراجعین به کلینیک خواب بیمارستان بهارلو در شرایط یکسان تحت تست پلی سونوگرافی فرار گرفتند در روز بعد از تست بعد از بیدار شدن از خواب و میل کردن صبحانه در یک اتاق آرام با تهویه ی مناسب تست های عصبی رفتاری انجام شد و همراهی آن با شاخص آپنه هیپوآپنه (AHI) مورد بررسی قرار گرفت.

نتایج: از میان 65 بیمار بررسی شده 43 نفر (2/66%) امتیاز AHI بالاتر از 15 داشتند. در آنالیز univariate تست های بنتون (Benton) ، aiming و SRT با عدد AHI ارتباطی نداشت (05/0 P >) اما تست های santaana (001/0 = P) و digitspan (043/0 = P) و Digit symbol (001/0 = P) به طور معناداری با امتیاز AHI در ارتباط بود و در افراد با امتیاز AHI 15 و پایین تر بهتر بود. در آنالیز Multivariate تست های santaana (001/0 = P) و digit span (04/0 = P) و Digit symbol (000/0= P) ، Qiming (01/0 = P) و SRT (000/0 = P) به طور معنی داری در بیماران با امتیاز AHI 15 و پایین تر بهتر بود ولی در مورد تست Benton تفاوت معنی داری بین دو گروه دیده نشد.

نتیجه گیری: نهایتاً با توجه به نتایج بدست آمده در این مطالعه، شاید بتوان اینطور نتیجه گیری کرد که اختلالات عصبی رفتاری در بین مبتلایان به آپنه انسدادی خواب شایع است و از این میان حافظه ی شنیداری از همه بیشتر دچار اختلال می گردد.

 

كليد واژه ها : اختلالات عصبی رفتاری ، خروپف ، اختلال تنفسی حین خواب

مشخصات دانشجو:

نام: انوشه نورانی

  رشته تحصيلي: تخصص طب کار

 مقطع: تخصص

  گروه آموزشي: طب کار دانشگاه تهران           

 پست الكترونيك دانشجو:  dr.anoosheh.n@gmail.com

اساتيد راهنما و داور:

استاد راهنما: دکتر امید امینیان   اساتيد مشاور: دکتر خسرو صادق نیت   اساتيد داور: دکتر رامین مهرداد، دکتر رضا پور یعقوب

دکتر مریم سرایی، دکتر نازنین ایزدی

زمان دفاع :

   روز: جهارشنبه

 تاريخ: 3/9/1395

  ساعت: 14:30

مكان دفاع به آدرس: گروه طب کار دانشکده علوم پزشکی تهران

اطلاعات به زبان انگليسي

Title: Evaluation of psychomotor performance in patients with obstructive sleep apnea syndrome

Abstract:

Background: Respiratory disorders, especially snoring, are common problems during sleep. Snoring results in neurobehavioral impairment due to hypoxia, increased sympathetic activity, increased nocturnal perspiration, as well as reduction in working memory, vigilance, and executive function. Regarding the importance of this issue, we performed his study to assess neurobehavioral impairment among snoring subjects.

Materials and Methods: In this cross-sectional study, 65 consecutive subjects attending the snoring clinic in Baharloo Hospital, Tehran, Iran, underwent polysomnography under the same conditions. On the next day, after waking up and eating breakfast in a calm room with desired ventilation, the neurobehavioral tests were performed and the association with apnea hypoapnea index (AHI) was assessed.

Results: Among the 65 patients, 43 (66.2%) had AHI scores higher than 15. In univariate analysis, the Benton, aiming, and simple reaction time (SRT) scores were not related to AHI scores (P>0.05); however, Santa Ana (P=0.001), digit-span (P=0.043), and digit-symbol (P=0.001) scores were significantly higher in those with AHI scores of 15 and lower. In multivariate analysis, the Santa Ana (P=0.001), digit-span (P=0.04), digit symbol (P=0.00), aiming (P=0.01), and SRT (P=0.00) scores were significantly better in those with AHI scores of 15 and less. No significant effect was observed in case of Benton test (P=0.47).

Conclusion: According to the obtained results, it may be concluded that neurobehavioral impairment is common among snorers and mainly the auditory memory is impaired in these subjects.

Keywords: Neurobehavioral impairment, Snoring, Sleep-disordered breathing

 

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منبع: معاونت پژوهشي دانشکده پزشکي