Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
J Sleep Res. 2012 Aug;21(4):427-33. doi: 10.1111/j.1365-2869.2011.00990.x. Epub 2011 Dec 12.
Existing research has demonstrated associations between sleep duration and obesity, diabetes, cardiovascular disease and mortality. Sleep disorders research has shown that sleep apnoea, insomnia and other sleep disorders confer risk for cardiometabolic disease, particularly in the presence of reduced sleep duration. The aim of the present study was to examine the associations between general sleep disturbance, operationalized as 'difficulty falling asleep, staying asleep, or sleeping too much' as measured in a large, nationally representative sample, and self-reported history of myocardial infarction, stroke, coronary artery disease, diabetes and obesity. Data from the Behavioral Risk Factor Surveillance System were analysed. Complete data were available for 138,201 individuals. A hierarchical logistic regression analysis examined associations before and after adjustment for demographic, socioeconomic, medical and psychological factors. After adjusting for demographic, socioeconomic and health risk factors, sleep duration was associated with obesity [odds ratio (OR)=1.18, P<0.0005), diabetes (OR=1.18, P<0.005), myocardial infarction (OR=1.36, P<0.0005), stroke (OR=1.22, P<0.05) and coronary artery disease (OR=1.59, P<0.0005). In fully adjusted models that included physical health, significant relationships remained for obesity (OR=1.14, P<0.0005), myocardial infarction (OR=1.23, P<0.005) and coronary artery disease (OR=1.43, P<0.0005). Sleep disturbance is a significant risk factor for obesity, diabetes, myocardial infarction, stroke and coronary artery disease, and effects for obesity, myocardial infarction and coronary artery disease are the most robust after adjustment. This study demonstrates that sleep disturbance is a novel risk factor that is potentially modifiable. Future research should determine whether sleep intervention could reduce the cardiometabolic consequences of sleep disturbance.
现有研究表明,睡眠时长与肥胖、糖尿病、心血管疾病和死亡率之间存在关联。睡眠障碍研究表明,睡眠呼吸暂停、失眠和其他睡眠障碍会增加患心血管疾病的风险,尤其是在睡眠时长减少的情况下。本研究旨在探讨在一个大型的全国代表性样本中,用“入睡困难、睡眠维持困难或睡眠过多”来衡量的一般睡眠障碍与心肌梗死、中风、冠状动脉疾病、糖尿病和肥胖的自我报告史之间的关联。分析了来自行为风险因素监测系统的数据。共有 138201 人提供了完整的数据。采用分层逻辑回归分析方法,在调整人口统计学、社会经济、医学和心理因素前后,对这些关联进行了分析。在调整了人口统计学、社会经济和健康风险因素后,睡眠时间与肥胖(OR=1.18,P<0.0005)、糖尿病(OR=1.18,P<0.005)、心肌梗死(OR=1.36,P<0.0005)、中风(OR=1.22,P<0.05)和冠状动脉疾病(OR=1.59,P<0.0005)相关。在包括身体健康状况的完全调整模型中,肥胖(OR=1.14,P<0.0005)、心肌梗死(OR=1.23,P<0.005)和冠状动脉疾病(OR=1.43,P<0.0005)仍存在显著相关性。睡眠障碍是肥胖、糖尿病、心肌梗死、中风和冠状动脉疾病的一个重要危险因素,且在调整后,肥胖、心肌梗死和冠状动脉疾病的影响最为显著。本研究表明,睡眠障碍是一个新的潜在可改变的危险因素。未来的研究应确定睡眠干预是否可以降低睡眠障碍对心血管代谢的影响。