The influence of non-breathing-related sleep fragmentation on cognitive function in patients with cerebral small vessel disease

BACKGROUND: Cognitive impairment in patients with cerebral small vessel disease (CSVD) is common, but the pathogenic mechanism is not well understood. The situation of non-breathing-related sleep fragmentation in CSVD patients and its influence on cognitive impairment is not clear. The aim of this study was to investigate the influence of non-breathing-related sleep fragmentation on cognitive function in patients with CSVD. METHODS: A group of 89 CSVD patients without breathing-related sleep disorders in the Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University was enrolled. The patients underwent magnetic resonance scan, polysomnography, cognitive function evaluation using Montreal Cognitive Assessment scale (MoCA), and Mini-Mental State Examination. The patients were assigned to study group (arousal index [ArI] ≥26.8/hour) or control group (ArI <26.8/hour) based on the average level of ArI (mean =26.8, SD =7.5) at night, and the cognitive function of the patients in the two groups was analyzed. RESULTS: The total MoCA score, the subscale scores of visuospatial ability and delayed recall in the study group were significantly lower than that in the control group (P<0.05). The cognitive impairment measured by MoCA was positively related to ArI level and %N-3 sleep according to the results of logistic regression (P<0.05). CONCLUSION: Non-breathing-related sleep fragmentation is associated with cognitive impairment in CSVD patients, especially executive function and delayed recall ability.