Boden-Albala Bernadette, Roberts Eric T, Bazil Carl, Moon Yeseon, Elkind Mitchell S V, Rundek Tatjana, Paik Myunghee C, Sacco Ralph L
Department of Health Policy, Mount Sinai School of Medicine, New York, NY, USA.
Circ Cardiovasc Qual Outcomes. 2012 Jul 1;5(4):500-7. doi: 10.1161/CIRCOUTCOMES.111.963801. Epub 2012 Jul 10.
Recent studies have suggested that poor quality and diminished quantity of sleep may be independently linked to vascular events although prospective and multiethnic studies are limited. This study aimed to explore the relationship between daytime sleepiness and the risk of ischemic stroke and vascular events in an elderly, multiethnic prospective cohort.
As part of the Northern Manhattan Study, the Epworth Sleepiness Scale was collected during the 2004 annual follow-up. Daytime sleepiness was trichotomized using previously reported cut points of no dozing, some dozing, and significant dozing. Subjects were followed annually for a mean of 5.1 years. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for stroke, myocardial infarction, and death outcomes. We obtained the Epworth Sleepiness Scale on 2088 community residents. The mean age was 73.5 ± 9.3 years; 64% were women; 17% were white, 20% black, 60% Hispanic, and 3% were other. Over 44% of the cohort reported no daytime dozing, 47% some dozing, and 9% significant daytime dozing. Compared with those reporting no daytime dozing, individuals reporting significant dozing had an increased risk of ischemic stroke (hazard ratio, 2.74 [95% confidence interval, 1.38-5.43]), all stroke (3.00 [1.57-5.73]), the combination of ischemic stroke, myocardial infarction, and vascular death (2.38 [1.50-3.78]), and all vascular events (2.48 [1.57-3.91]), after adjusting for medical comorbidities.
Daytime sleepiness is an independent risk factor for stroke and other vascular events. These findings suggest the importance of screening for sleep problems at the primary care level.
近期研究表明，睡眠质量差和睡眠时间减少可能与血管事件独立相关，尽管前瞻性和多民族研究有限。本研究旨在探讨老年多民族前瞻性队列中白天嗜睡与缺血性中风及血管事件风险之间的关系。
作为北曼哈顿研究的一部分，2004年年度随访期间收集了爱泼华嗜睡量表。根据先前报道的无打瞌睡、偶尔打瞌睡和经常打瞌睡的切点，将白天嗜睡情况分为三类。对受试者进行平均5.1年的年度随访。采用Cox比例风险模型计算中风、心肌梗死和死亡结局的风险比及95%置信区间。我们获取了2088名社区居民的爱泼华嗜睡量表数据。平均年龄为73.5±9.3岁；64%为女性；17%为白人，20%为黑人，60%为西班牙裔，3%为其他种族。超过44%的队列参与者报告无白天打瞌睡，47%偶尔打瞌睡，9%经常白天打瞌睡。与报告无白天打瞌睡的人相比，报告经常打瞌睡的个体在调整医疗合并症后，发生缺血性中风的风险增加（风险比，2.74[95%置信区间，1.38 - 5.43]），所有中风（3.00[1.57 - 5.73]），缺血性中风、心肌梗死和血管性死亡的联合事件（2.38[1.50 - 3.78]），以及所有血管事件（2.48[1.57 - 3.91]）。
白天嗜睡是中风和其他血管事件的独立危险因素。这些发现表明在初级保健层面筛查睡眠问题的重要性。
