Changes of serum levels of hypothalamic-pituitary-adrenal axis hormones and its correlation with sleep quality and cognitive function in elderly patients with chronic insomnia
JIANG Wei1 SONG Wandeng1 ZHANG Fubin2 HUANG Yan1 HE Youjun1 HU Xin1
1.Department of General Medicine, the 901th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Anhui Province, Hefei 230031, China;
2.Department of Emergency, the 901th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Anhui Province, Hefei 230031, China
Abstract：Objective To investigate the changes of serum levels of hypothalamic-pituitary-adrenal axis (HPA) hormones (corticotropin-releasing hormone [CRH], adrenocorticotropic hormone [ACTH], cortisol [COR]) and its correlation with sleep quality and cognitive function in elderly patients with chronic insomnia. Methods A total of 88 elderly patients with chronic insomnia in the 901th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army (hereinafter referred to as “our hospital”) from June 2019 to June 2021 were selected as the observation group, and 80 healthy subjects in our hospital during the same period were selected as the control group. Serological HPA hormones indicators (CRH, ACTH, COR), photoplethysmography monitoring indicators (total sleep time, sleep latency, sleep efficiency, arousal times), and sleep and cognition related scales (Pittsburgh sleep quality index [PSQI], insomnia severity index [ISI], mini-mental state examination [MMSE], and Montreal cognitive assessment [MoCA]) scores were compared between the two groups, the correlation between serological indexes and sleep and cognitive indexes in elderly patients with chronic insomnia was analyzed. Results The serum levels of CRH, COR, sleep latency, arousal times, PSQI, and ISI in the observation group were higher than those in the control group, the total sleep time, sleep efficiency, and scores of MMSE, MoCA in the observation group were lower than those in the control group, the differences were statistically significant (P＜0.05). Correlation analysis results showed that serum CRH and COR levels were positively correlated with sleep latency, wake times, PSQI, and ISI scores (r＞0, P＜0.05), and negatively correlated with total sleep time, sleep efficiency, and scores of MMSE, MoCA (r＜0, P＜0.05). Conclusion The increase of serum CRH and COR levels in elderly patients with chronic insomnia is closely related to the decline of sleep quality and cognitive impairment.
江伟1 宋万灯1 章福彬2 黄艳1 何友军1 胡欣1. 老年慢性失眠患者血清下丘脑-垂体-肾上腺轴激素水平变化及其与睡眠质量和认知功能的相关性[J]. 中国医药导报, 2023, 20(2): 122-125.
JIANG Wei1 SONG Wandeng1 ZHANG Fubin2 HUANG Yan1 HE Youjun1 HU Xin1. Changes of serum levels of hypothalamic-pituitary-adrenal axis hormones and its correlation with sleep quality and cognitive function in elderly patients with chronic insomnia. 中国医药导报, 2023, 20(2): 122-125.
[1] Patel D，Steinberg J，Patel P. Insomnia in the Elderly：A Review [J]. J Clin Sleep Med，2018，14（6）：1017-1024.
[2] Abad VC，Guilleminault C. Insomnia in Elderly Patients：Recommendations for Pharmacological Management [J]. Drugs Aging，2018，35（9）：791-817.
[3] Brownlow JA，Miller KE，Gehrman PR. Insomnia and Cognitive Performance [J]. Sleep Med Clin，2020，15（1）：71-76.
[4] Sadeghmousavi S，Eskian M，Rahmani F，et al. The effect of insomnia on development of Alzheimer’s disease [J]. J Neuroinflammation，2020，17（1）：289.
[5] Agorastos A，Olff M. Sleep，circadian system and traumatic stress [J]. Eur J Psychotraumatol，2021，12（1）：1956746.
[6] Kalmbach DA，Anderson JR，Drake CL. The impact of stress on sleep：Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders [J]. J Sleep Res，2018，27（6）：e12710.
[7] Sroykham W，Wongsawat Y. Effects of brain activity，morning salivary cortisol，and emotion regulation on cognitive impairment in elderly people [J]. Medicine（Baltimore），2019， 98（26）：e16114.
[8] Yao Z，Liu B，Wang Y，et al. High cortisol and the risk of Alzheimer disease：A protocol for systematic review and meta- analysis [J]. Medicine （Baltimore），2021，100（39）：e27319.
[9] Perez MN，Salas RME. Insomnia [J]. Continuum（Minneap Minn），2020，26（4）：1003-1015.
[10] 刘贤臣，唐茂芹，胡蕾，等.匹兹堡睡眠质量指数的信度和效度研究[J].中华精神科杂志，1996（2）：103-107.
[11] Vulcan RS，André S，Bruyneel M. Photoplethysmography in Normal and Pathological Sleep [J]. Sensors（Basel），2021，21（9）：2928.
[12] Morin CM，Belleville G，Bélanger L，et al. The Insomnia Severity Index：psychometric indicators to detect insomnia cases and evaluate treatment response [J]. Sleep，2011，34（5）：601-608.
[13] Devenney E，Hodges JR. The Mini-Mental State Examination：pitfalls and limitations [J]. Pract Neurol，2017，17（1）：79-80.
[14] Chen X，Zhang R，Xiao Y，et al. Reliability and Validity of the Beijing Version of the Montreal Cognitive Assessment in the Evaluation of Cognitive Function of Adult Patients with OSAHS [J]. PLoS One，2015，10（7）：e0132361.
[15] Sexton CE，Sykara K，Karageorgiou E，et al. Connections Between Insomnia and Cognitive Aging [J]. Neurosci Bull，2020，36（1）：77-84.
[16] Dzierzewski JM，Dautovich N，Ravyts S. Sleep and Cognition in Older Adults [J]. Sleep Med Clin，2018，13（1）：93- 106.
[17] 张翠红，张洁，王晶，等.不同类型失眠的多导睡眠监测特点[J].世界睡眠医学杂志，2021，8（7）：1285-1287.
[18] 潘虹，黄国平，任蓉，等.光电容积脉搏波描记法对阻塞性睡眠呼吸暂停综合征的诊断价值[J].中华医学杂志，2016，96（19）：1527-1529.
[19] 陈敏，宋清扬，李敏，等.老年慢性失眠患者睡眠质量与认知功能的相关性[J].国际精神病学杂志，2021，48（2）：251-254.
[20] 胡裕洁，杨国帅，张艳君，等.老年慢性失眠相关认知障碍的危险因素分析[J].国际神经病学神经外科学杂志，2020，47（2）：152-156.
[21] Dressle RJ，Feige B，Spiegelhalder K，et al. HPA axis activity in patients with chronic insomnia：A systematic review and meta-analysis of case-control studies [J]. Sleep Med Rev，2022，62：101588.
[22] 杨叶.慢性失眠患者压力-觉醒状态与HPA轴活性的相关性研究[D].合肥：安徽医科大学，2021.
[23] Schüssler P，Kluge M，Gamringer W，et al. Corticotropin- releasing hormone induces depression-like changes of sleep electroencephalogram in healthy women [J]. Psychoneuroendocrinology，2016，74：302-307.
[24] 孔晓艺，胡婷，葛义俊，等.慢性失眠患者日间脑功能状态改变及其与血清生物学标志和睡眠质量的相关性[J].中华医学杂志，2021，101（4）：249-253.
[25] 邱正法，华玖州，田海华.青年首发抑郁症患者皮质醇与脑电图特征及认知功能变化相关性分析[J].中国医药导报，2020，17（17）：137-140.
京公网安备 11010502046598号