폐쇄성 수면무호흡증 환자의 주의력 결함 및 수면다원검사 특징
Attention Deficits and Characteristics of Polysomnograms in Patients with Obstructive Sleep Apnea
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초록
본 연구에서는 폐쇄성 수면 무호흡증 환자(obstructive sleep Apnea, OSA)의 연령수준에 따른 주의력 결함 특성을 알아보고, 이들의 주의력 결함이 어떤 수면다원검사 지표들과 관련이 있는지 검토하고자 하였다. 두 하위 연령집단 및 정상군에 대해 전산화 주의력측정검사인 연속수행과제와 변화맹시과제를 실시하였다. 추가적으로 수면다원검사의 하위 지표들을 추출하고 주관적 주간졸음을 측정하는 엡워스 주간 졸리움 척도도 실시하였다. 연구결과, OSA군은 정상군과 비교하여 연속수행과제에서 누락 오류와 오경보 오류의 수가 유의하게 많은 것으로 나타났고, 변화맹시 과제에서 정반응률이 유의하게 낮은 것으로 나타났다. 상관분석 결과, OSA군의 주의력 결함은 수면다원검사 지표들 중 저산소혈증과 유의한 상관을 보였다. 결론적으로, OSA군은 부주의하고, 반응억제에 어려움을 보이며, 환경적 자극들 사이에서 일어나는 중요한 변화를 탐지하는데 결함이 있는 것으로 나타났다. 이러한 주의력 결함의 정도는 연령이 증가함에 따라 더욱 심화되었다. 특히 주의력 결함과 비가역적 대뇌 손상을 초래하는 저산소혈증과의 관련성은 OSA 환자의 인지기능의 손상을 예방하기 위해 조기치료가 필요함을 시사한다.
Abstract
This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.
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