Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study

Abstract Objectives To assess the correlation of cognitive function with sleep stability and depressive‐anxious symptoms in insomnia patients. Methods Twenty‐two insomnia patients with cognitive impairment (insomnia‐CI), 21 insomnia patients with normal cognition (insomnia‐CN), and 15 matched health...

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Main Authors: Xuan Zhang, Bingxin Song, Yanyan Liu, Yahui Wan, Kaili Zhou, Rong Xue
Format: Article
Language:English
Published: Wiley 2021-06-01
Series:Brain and Behavior
Subjects:
Online Access:https://doi.org/10.1002/brb3.2068
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author Xuan Zhang
Bingxin Song
Yanyan Liu
Yahui Wan
Kaili Zhou
Rong Xue
author_facet Xuan Zhang
Bingxin Song
Yanyan Liu
Yahui Wan
Kaili Zhou
Rong Xue
author_sort Xuan Zhang
collection DOAJ
description Abstract Objectives To assess the correlation of cognitive function with sleep stability and depressive‐anxious symptoms in insomnia patients. Methods Twenty‐two insomnia patients with cognitive impairment (insomnia‐CI), 21 insomnia patients with normal cognition (insomnia‐CN), and 15 matched healthy control subjects (HCs) were enrolled and completed neuropsychological tests, the Hamilton Depression and Anxiety Scales (HAMD and HAMA), the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index (PSQI),the Insomnia Severity Index (ISI), and the cardiopulmonary coupling (CPC) examination. Ratios of high‐frequency coupling (HFC), low‐frequency coupling (LFC), and very low‐frequency coupling (VLFC) measured by CPC analysis represent stable sleep, unstable sleep, and wake/rapid eye movement (REM) sleep, respectively. Results The HAMD, HAMA, PSQI, and ISI scores were higher in the insomnia‐CN patients than in the HCs (all p < .01). However, no differences were found in the HFC, LFC, and VLFC ratio between the HCs and insomnia‐CN groups. Compared with the insomnia‐CN patients, insomnia‐CI patients exhibited higher scores on the HAMD, HAMA (all p < .01), and PSQI (p < .05), performed worse on the Auditory Verbal Learning Test, Trial Making Test B, and Stroop Test B (all p < .01), had a lower HFC ratio, and had a higher LFC ratio in the CPC analysis (all p < .01). Furthermore, in the insomnia patients, poorer cognition was correlated with a decreased HFC ratio and an increased VLFC ratio (r = .356, p = .019; r = −.339, p =.026, respectively) and increased HAMD and HAMA scores (r = −.507, p < .001; r = −.561, p < .001, respectively); a higher VLFC ratio was correlated with an increased ISI score (r = .346, p = .023). Conclusions Cognitive deterioration in insomnia patients was associated with a decreased stable sleep ratio, an increased wake/REM sleep ratio and more severe symptoms of depression and anxiety. CPC analysis can reflect the severity of insomnia.
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spelling doaj.art-bea6023811a841ceb2d5c30e6909689d2022-12-21T22:48:45ZengWileyBrain and Behavior2162-32792021-06-01116n/an/a10.1002/brb3.2068Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling studyXuan Zhang0Bingxin Song1Yanyan Liu2Yahui Wan3Kaili Zhou4Rong Xue5Department of Neurology Tianjin Medical University General Hospital Airport Site Tianjin ChinaDepartment of Neurology Tianjin Medical University General Hospital Tianjin ChinaDepartment of Neurology Tianjin Medical University General Hospital Tianjin ChinaDepartment of Neurology Tianjin Medical University General Hospital Airport Site Tianjin ChinaDepartment of Neurology Tianjin Medical University General Hospital Airport Site Tianjin ChinaDepartment of Neurology Tianjin Medical University General Hospital Airport Site Tianjin ChinaAbstract Objectives To assess the correlation of cognitive function with sleep stability and depressive‐anxious symptoms in insomnia patients. Methods Twenty‐two insomnia patients with cognitive impairment (insomnia‐CI), 21 insomnia patients with normal cognition (insomnia‐CN), and 15 matched healthy control subjects (HCs) were enrolled and completed neuropsychological tests, the Hamilton Depression and Anxiety Scales (HAMD and HAMA), the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index (PSQI),the Insomnia Severity Index (ISI), and the cardiopulmonary coupling (CPC) examination. Ratios of high‐frequency coupling (HFC), low‐frequency coupling (LFC), and very low‐frequency coupling (VLFC) measured by CPC analysis represent stable sleep, unstable sleep, and wake/rapid eye movement (REM) sleep, respectively. Results The HAMD, HAMA, PSQI, and ISI scores were higher in the insomnia‐CN patients than in the HCs (all p < .01). However, no differences were found in the HFC, LFC, and VLFC ratio between the HCs and insomnia‐CN groups. Compared with the insomnia‐CN patients, insomnia‐CI patients exhibited higher scores on the HAMD, HAMA (all p < .01), and PSQI (p < .05), performed worse on the Auditory Verbal Learning Test, Trial Making Test B, and Stroop Test B (all p < .01), had a lower HFC ratio, and had a higher LFC ratio in the CPC analysis (all p < .01). Furthermore, in the insomnia patients, poorer cognition was correlated with a decreased HFC ratio and an increased VLFC ratio (r = .356, p = .019; r = −.339, p =.026, respectively) and increased HAMD and HAMA scores (r = −.507, p < .001; r = −.561, p < .001, respectively); a higher VLFC ratio was correlated with an increased ISI score (r = .346, p = .023). Conclusions Cognitive deterioration in insomnia patients was associated with a decreased stable sleep ratio, an increased wake/REM sleep ratio and more severe symptoms of depression and anxiety. CPC analysis can reflect the severity of insomnia.https://doi.org/10.1002/brb3.2068cardiopulmonary coupling analysisinsomnianeuropsychological performancesleep stability
spellingShingle Xuan Zhang
Bingxin Song
Yanyan Liu
Yahui Wan
Kaili Zhou
Rong Xue
Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study
Brain and Behavior
cardiopulmonary coupling analysis
insomnia
neuropsychological performance
sleep stability
title Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study
title_full Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study
title_fullStr Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study
title_full_unstemmed Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study
title_short Cognitive deficit is correlated with sleep stability in insomnia: A cardiopulmonary coupling study
title_sort cognitive deficit is correlated with sleep stability in insomnia a cardiopulmonary coupling study
topic cardiopulmonary coupling analysis
insomnia
neuropsychological performance
sleep stability
url https://doi.org/10.1002/brb3.2068
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