Correlation between cognitive decline and the degree of sleep apnea in patients with chronic obstructive pulmonary disease

doi:10.3877/cma.j.issn.1674-6902.2025.03.009

Abstract

Abstract:

Objective

To analyze the clinical analysis between the severity of sleep apnea and the risk of cognitive decline in patients with chronic obstructive pulmonary disease （COPD）.

Methods

A total of 118 COPD patients admitted to our hospital from January 2022 to August 2024 were enrolled. They were divided into four groups based on the apnea hypopnea index （AHI）：control group 38 cases （AHI＜5 events/h），mild group 38 cases （5 events/h≤AHI＜15 events/h），moderate group 30 cases （15 events/h≤AHI＜30 events/h），and severe group12 cases （ AHI≥30 events/h）. General data，pulmonary function，and cognitive function were compared among the groups. Pearson correlation analysis and multiple linear regression were used to assess the correlation between sleep apnea severity and cognitive function in COPD patients.

Results

Significant differences were observed among the groups in forced expiratory volume in the first second/forced vital capacity（FEV₁/FVC） and forced expiratory volume in the first second as a percentage of predicted value （FEV₁%Pred）. The FEV₁/FVC values for the control，mild，moderate，and severe groups were （61.25±4.09）%，（58.64±5.17）%，（52.65±6.22）%，and （48.97±4.19）%，respectively. FEV₁%Pred values were （75.33±2.75）%，（72.61±4.86）%，（62.64±5.44）%，and （58.67±4.59）%，respectively. The severe group had significantly lower FEV₁/FVC and FEV₁%Pred compared to the control，mild，and moderate groups （P ＜0.05）. Significant differences were also observed in visuospatial/executive function，attention，memory，and total Montreal Cognitive Assessment Scale （MoCA） scores among the groups （P＜0.05）. The severe group scored （3.31±0.67），（4.66±0.15），（3.52±0.29），and （24.18±2.01） in these domains，respectively，while the control group scored （4.58±0.12），（5.61±0.27），（4.39±0.24），and （28.33±1.17）（P＜0.05）. Pearson correlation analysis revealed a negative correlation between AHI and MoCA scores （r=-0.616，P =0.001）.Multiple stepwise regression analysis indicated that AHI negatively impacted cognitive function in COPD patients （P ＜0.05）. Among 118 patients with OSA and CODP who had cognitive decline，98（83.05%）survived after treatment，and 20（16.95%） died due to poor treatment efficacy.

Conclusion

The severity of sleep apnea is associated with the risk of cognitive decline in COPD patients. Assessing sleep apnea in COPD patients and implementing early interventions may help reduce the risk of cognitive impairment.

Key words: Chronic obstructive pulmonary disease, Sleep apnea, Cognitive function, Clinical nanlysis

Dan Wang, Changfeng Wang, Li Wang, Bin Qi, Yuanyuan Ye, Hao Fan. Correlation between cognitive decline and the degree of sleep apnea in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(03): 390-394.

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References 30

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组别	例数	受教育年限 [年,(x̄ ± s)]	体质量指数 [kg/m²,(x̄ ± s)]	吸烟史 [n(%)]	COPD 病程 [年,(x̄ ± s)]	合并症指数 (x̄ ± s)	肺气肿 [n(%)]
对照组	38	10.22±2.47	23.08±2.39	15(39.47)	6.14±1.90	3.29±1.02	5(13.16)
轻度组	38	10.19±2.85	23.19±2.48	16(42.11)	6.44±1.87	3.41±1.01	9(23.68)
中度组	30	10.33±2.74	23.22±2.57	13(43.33)	6.42±1.85	3.33±1.06	8(30.00)
重度组	12	10.22±2.66	23.33±2.42	6(50.00)	6.37±1.79	3.38±1.04	6(50.00)
F/χ²		0.017	0.038	0.415	0.200	0.093	7.350
P 值		0.997	0.990	0.937	0.896	0.964	0.062

组别	例数	受教育年限 [年,(x̄ ± s)]	体质量指数 [kg/m²,(x̄ ± s)]	吸烟史 [n(%)]	COPD 病程 [年,(x̄ ± s)]	合并症指数 (x̄ ± s)	肺气肿 [n(%)]
对照组	38	10.22±2.47	23.08±2.39	15(39.47)	6.14±1.90	3.29±1.02	5(13.16)
轻度组	38	10.19±2.85	23.19±2.48	16(42.11)	6.44±1.87	3.41±1.01	9(23.68)
中度组	30	10.33±2.74	23.22±2.57	13(43.33)	6.42±1.85	3.33±1.06	8(30.00)
重度组	12	10.22±2.66	23.33±2.42	6(50.00)	6.37±1.79	3.38±1.04	6(50.00)
F/χ²		0.017	0.038	0.415	0.200	0.093	7.350
P 值		0.997	0.990	0.937	0.896	0.964	0.062

组别	例数	视空间/执行功能	命名功能	注意力	语言功能	抽象思维	记忆力	定向力	MOCA 总评分
对照组	38	4.58±0.12	2.64±0.31	5.61±0.27	2.70±0.31	1.78±0.23	4.39±0.24	5.67±0.22	28.33±1.17
轻度组	38	4.26±0.44	2.64±0.26	5.10±0.22	2.58±0.37	1.69±0.24	4.15±0.16	5.65±0.37	26.93±2.15
中度组	30	4.01±0.52	2.60±0.24	4.98±0.19	2.52±0.41	1.67±0.23	3.98±0.34	5.60±0.29	25.67±2.67
重度组	12	3.31±0.67	2.58±0.27	4.66±0.15	2.49±0.37	1.64±0.32	3.52±0.29	5.54±0.30	24.18±2.01
F 值		30.090	0.267	76.920	1.845	1.734	39.840	0.737	16.890
P 值		0.001	0.849	0.001	0.143	0.164	0.001	0.532	0.001

组别	例数	视空间/执行功能	命名功能	注意力	语言功能	抽象思维	记忆力	定向力	MOCA 总评分
对照组	38	4.58±0.12	2.64±0.31	5.61±0.27	2.70±0.31	1.78±0.23	4.39±0.24	5.67±0.22	28.33±1.17
轻度组	38	4.26±0.44	2.64±0.26	5.10±0.22	2.58±0.37	1.69±0.24	4.15±0.16	5.65±0.37	26.93±2.15
中度组	30	4.01±0.52	2.60±0.24	4.98±0.19	2.52±0.41	1.67±0.23	3.98±0.34	5.60±0.29	25.67±2.67
重度组	12	3.31±0.67	2.58±0.27	4.66±0.15	2.49±0.37	1.64±0.32	3.52±0.29	5.54±0.30	24.18±2.01
F 值		30.090	0.267	76.920	1.845	1.734	39.840	0.737	16.890
P 值		0.001	0.849	0.001	0.143	0.164	0.001	0.532	0.001

变量	非标准化系数		标准化系数	t 值	P 值	95%CI
变量	B	标准误	Beta	t 值	P 值	下限	上限
常数	31.197	3.114		10.018	0.001	25.028	37.365
AHI	-0.137	0.023	-0.702	-5.826	0.001	-0.183	-0.090
FEV₁/FVC%	0.002	0.023	0.006	0.067	0.946	-0.061	0.065
FEV₁%Pred	-0.037	0.034	-0.121	-1.095	0.276	-0.103	0.030

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