目的：探讨慢性失眠患者认知功能与主客观睡眠质量、血清总 Tau 蛋白（t-Tau）、磷酸化 Tau 蛋白 （p-Tau）水平的相关性。方法：慢性失眠患者52例纳入失眠组，健康人20例纳入对照组。行多导睡眠监测、 匹兹堡睡眠质量指数（PSQI）评估受试者的主观、客观睡眠质量；蒙特利尔认知功能量表（MoCA）评估总体 认知功能；测定血清t-Tau、p-Tau水平。结果：慢性失眠患者PSQI得分、睡眠潜伏期、N1%高于对照组（均 P＜0.05），睡眠效率、N3%及快速动眼（REM）%低于对照组（均P＜0.05）；MoCA总分及视空间与执行功能、 注意力、记忆力评分低于对照组（均 P＜0.05）；血清 t-Tau、p-Tau 高于对照组（均 P＜0.05）。慢性失眠患者 MoCA评分与N3%、REM%水平呈线性正相关，与PSQI评分、N1%、p-Tau水平呈线性负相关（均P＜0.05）。 结论：慢性失眠患者认知功能降低，可能与睡眠质量下降、睡眠结构紊乱及血清p-Tau蛋白水平升高有关。

To investigate the correlation between cognitive function and sleep quality, serum total tau protein (t-Tau), and phosphorylated Tau protein (p-Tau) in patients with chronic insomnia. Methods: We selected 52 patients with chronic insomnia for the insomnia group and 20 healthy individuals for the control group. Polysomnography and the Pittsburgh sleep quality index (PSQI) were used to assess objective and subjective sleep quality, and the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate overall cognitive function. Serum t-Tau and p-Tau levels were measured. Results: PSQI score, sleep latency, and N1% of chronic insomnia patients were higher and sleep efficiency, N3%, and REM% were lower than those of the control group, and the difference was statistically significant (all P<0.05). MoCA total score, visual space and executive function, attention, and memory score of the insomnia group were lower than those of the control group (all P<0.05). Serum t-Tau and p-Tau of chronic insomnia patients were higher than those of control patients (both P<0.05). Correlation analysis showed that MoCA score was positively correlated with N3% and REM% and negatively correlated with PSQI score, N1%, and p-Tau level (P<0.05). Conclusion: Cognitive function of patients with chronic insomnia is impaired, and this is probably related to the reduced sleep quality, disordered sleep structure, and increased serum p-Tau protein level.