阻塞性睡眠呼吸暂停低通气综合征对飞行员认知功能的影响

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对飞行员认知功能的影响.方法 对13名经多导睡眠图(PSG)确诊的中重度OSAHS患者及10名正常体检健康飞行员进行Epworth嗜睡程度问卷(ESS)评分,以及进行闪光融合频率、多项反应时、空间位置记忆广度、注意力集中能力、警戒性等认知功能测试,并对OSAHS组进行ESS评分、睡眠呼吸紊乱指数(AHI)、最低血氧饱和度与各项认知功能测试结果间进行相关性分析.结果 OSAHS组ESS评分明显高于对照组(P＜0.01),闪光融合频率、空间位置记忆广度分值、注意力集中能力时间明显低于对照组(P＜0.05或P＜0.01),对黄、绿色的选择反应时明显慢于对照组(P＜0.05),对红色的选择反应时与对照组相比无显著差异.OSAHS组警戒性作业总错误率明显高于对照组(P＜0.01).OSAHS组ESS评分与警戒性作业的总错误率呈显著正相关(r=0.789 0,＜0.01).结论 中重度OSAHS患者有不同程度的认知功能减退,可能损害飞行操作能力,造成飞行安全隐患.临床未进行有效治疗的患者应暂时或永久取消飞行资格.

Effect of obstructive sleep apnea/hypopnea syndrome (OSAHS) on the cognitive function of pilots

Objective To explore the effects of obstructive sleep apnea/hypopnea syndrome (OSAHS) on the cognitive function of pilots. Methods The cognitive function of 13 pilots diagnosed as severe OSAHS and 10 healthy pilots as control was evaluated using Epworth Sleepiness Scale (ESS), Flicker Fusion Frequency Indicator, Many Reaction Time Tester, Space Place Memory Span Tester, Attention Instrument and Guard Tester. The correlation analyses were also performed between the ESS, AHI, MinSaO2% with the results of each cognitive test in the OSAHS group. Results Compared with the healthy control subjects, the scores of ESS in OSAHS group were significantly higher (P<0.01), while the flicker fusion frequency and the scores of space place memory span were significantly lower (P<0.05, P<0.01). The time of attention in OSAHS group was also significantly shorter than that in the healthy control group (P<0.01). In many reaction time test, the selective reaction time to yellow and green was much longer in OSAHS group, while there was no significant difference between the two groups in red reaction time. The error rate of guard task was significantly higher in OSAHS group (P<0.01), and a positive correlation existed between the ESS and the error rate of guard task in OSAHS group (r=0.789, P<0.01). Conclusion Pilots suffered from moderate or severe OSAHS may usually have cognitive handicap to some degree, which may deteriorate the ability of flying performance. Therefore, the pilots diagnosed as OSAHS should not be allowed to perform flying task until their disorders be effectively taken care of.