Section of Critical Care, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Am J Cardiol. 2013 Feb 15;111(4):547-51. doi: 10.1016/j.amjcard.2012.10.038. Epub 2012 Dec 6.
Although sleep quality and duration have been related to cardiovascular end points, little is known about the association between sleep duration and incident atrial fibrillation (AF). Hence, we prospectively examined the association between sleep duration and incident AF in a cohort of 18,755 United States male physicians. Self-reported sleep duration was ascertained during a 2002 annual follow-up questionnaire. Incident AF was ascertained through annual follow-up questionnaires. Cox regression analysis was used to estimate the relative risks of AF. The average age at baseline was 67.7 ± 8.6 years. During a mean follow-up of 6.9 ± 2.1 years, 1,468 cases of AF occurred. Using 7 hours of sleep as the reference group, the multivariate adjusted hazard ratio for AF was 1.06 (95% confidence interval 0.92 to 1.22), 1.0 (reference), and 1.13 (95% confidence interval 1.00 to 1.27) from the lowest to greatest category of sleep duration (p for trend = 0.26), respectively. In a secondary analysis, no evidence was seen of effect modification by adiposity (p for interaction = 0.69); however, prevalent sleep apnea modified the relation of sleep duration with AF (p for interaction = 0.01). From the greatest to the lowest category of sleep duration, the multivariate-adjusted hazard ratio for AF was 2.26 (95% confidence interval 1.26 to 4.05), 1.0 (reference), and 1.34 (95% confidence interval 0.73 to 2.46) for those with prevalent sleep apnea and 1.01 (95% confidence interval 0.87 to 1.16), 1.0 (reference), and 1.12 (95% confidence interval 0.99 to 1.27) for those without sleep apnea, respectively. Our data showed a modestly elevated risk of AF with long sleep duration among United States male physicians. Furthermore, a shorter sleep duration was associated with a greater risk of AF in those with prevalent sleep apnea.
虽然睡眠质量和时长与心血管终点事件有关，但人们对睡眠时长与房颤（AF）发病之间的关系知之甚少。因此，我们前瞻性地研究了在美国男性医生队列中，睡眠时长与房颤发病之间的关系。通过 2002 年的年度随访问卷确定自我报告的睡眠时长。通过年度随访问卷确定房颤发病情况。使用 Cox 回归分析来估计房颤的相对风险。基线时的平均年龄为 67.7 ± 8.6 岁。在平均 6.9 ± 2.1 年的随访期间，有 1468 例房颤发生。以 7 小时的睡眠时长为参考组，睡眠时间最短至最长组的多变量校正后的房颤发病风险比分别为 1.06（95%置信区间 0.92 至 1.22）、1.0（参考）和 1.13（95%置信区间 1.00 至 1.27）（趋势检验 p 值=0.26）。在二次分析中，肥胖对睡眠时间与房颤发病关系的修饰作用无明显证据（交互检验 p 值=0.69）；然而，现患睡眠呼吸暂停改变了睡眠时长与房颤发病的关系（交互检验 p 值=0.01）。从睡眠时间最长到最短组，现患睡眠呼吸暂停者的房颤发病多变量校正风险比为 2.26（95%置信区间 1.26 至 4.05）、1.0（参考）和 1.34（95%置信区间 0.73 至 2.46），无睡眠呼吸暂停者的相应风险比为 1.01（95%置信区间 0.87 至 1.16）、1.0（参考）和 1.12（95%置信区间 0.99 至 1.27）。我们的数据显示，美国男性医生中，睡眠时长较长与房颤发病风险略有增加有关。此外，在现患睡眠呼吸暂停者中，较短的睡眠时长与房颤发病风险的增加有关。
