Effects of noninvasive mechanical ventilation on sleepand cognitive function in patients with chronic obstructive pulmonary disease combined with respiratory failure

Abstract

Objective To explore the effectand related mechanisms of noninvasive mechanical ventilation on sleep and cognitive function in chronic obstructive pulmonary disease (COPD) patients with respiratory failure.The purpose is to improve the compliance of noninvasive mechanical ventilation for COPD, and provide reference for clinical intervention and treatment in time. Methods One hundred and twelve patients with acute exacerbation of COPD in our hospital from January 2016 to June 2017.The scale of pittsburgh sleep quality index (PSQI), montreal cognitive assessment (MoCA)and mini-mental state examination (MMSE) were used to evaluate the sleep and cognitive function in COPD complicated with respiratory failure group and COPD control group.The basic data of each group and the difference of sleep and cognitive function before and after treatment were compared. Results The PSQI scores of COPD patients in respiratory failure group were higher than those in non respiratory failure group and normal control group, but the total scores of MoCA and MMSE was obviously lower.The differences of total scores between each group were statistically significant.The spatial execution, nomenclature, concentration of attention, language calculation, abstract thinking and recall scores were significantly lower in patients with COPD combined with respiratory failure, especially combined with type Ⅱ respiratory failure.After the noninvasive mechanical ventilation treatment, the scores of PSQI, MoCA and MMSE were improved more than before. Compared with before treatment, the scores of spatial execution, naming, attention, language calculation, orientationand recall were all higher.The differences were statistically significant. Conclusions Respiratory failure may be one of the most important factors that aggravate the abnormal sleep and cognitive dysfunction in COPD patients.This effect has a certain rever sibility.Positive control of the disease, timely and effective correction of respiratory failure, is conducive to improving cognitive function and sleep symptoms. Key words: Chronic obstructive pulmonary disease; Respiratory failure; Sleep; Cognitive function; Noninvasive mechanical ventilation