Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mail-Stop K-67, Atlanta, GA 30341, USA.
BMC Public Health. 2013 Jan 29;13:84. doi: 10.1186/1471-2458-13-84.
Although evidence suggests that poor sleep is associated with chronic disease, little research has been conducted to assess the relationships between insufficient sleep, frequent mental distress (FMD ≥14 days during the past 30 days), obesity, and chronic disease including diabetes mellitus, coronary heart disease, stroke, high blood pressure, asthma, and arthritis.
Data from 375,653 US adults aged ≥ 18 years in the 2009 Behavioral Risk Factor Surveillance System were used to assess the relationships between insufficient sleep and chronic disease. The relationships were further examined using a multivariate logistic regression model after controlling for age, sex, race/ethnicity, education, and potential mediators (FMD and obesity).
The overall prevalence of insufficient sleep during the past 30 days was 10.4% for all 30 days, 17.0% for 14-29 days, 42.0% for 1-13 days, and 30.6% for zero day. The positive relationships between insufficient sleep and each of the six chronic disease were significant (p < 0.0001) after adjustment for covariates and were modestly attenuated but not fully explained by FMD. The relationships between insufficient sleep and both diabetes and high blood pressure were also modestly attenuated but not fully explained by obesity.
Assessment of sleep quantity and quality and additional efforts to encourage optimal sleep and sleep health should be considered in routine medical examinations. Ongoing research designed to test treatments for obesity, mental distress, or various chronic diseases should also consider assessing the impact of these treatments on sleep health.
尽管有证据表明睡眠不佳与慢性疾病有关，但很少有研究评估睡眠不足、频繁精神困扰（过去 30 天内≥14 天）、肥胖与包括糖尿病、冠心病、中风、高血压、哮喘和关节炎在内的慢性疾病之间的关系。
利用 2009 年行为风险因素监测系统中 375653 名年龄≥18 岁的美国成年人的数据，评估过去 30 天内睡眠不足与慢性疾病之间的关系。在控制年龄、性别、种族/民族、教育程度和潜在中介因素（精神困扰和肥胖）后，使用多变量逻辑回归模型进一步检查这些关系。
过去 30 天内所有 30 天、14-29 天、1-13 天和零天的睡眠不足总体流行率分别为 10.4%、17.0%、42.0%和 30.6%。在调整了协变量后，睡眠不足与六种慢性疾病中的每一种都呈显著正相关（p<0.0001），但精神困扰可以部分解释这种相关性，而肥胖只能部分解释与糖尿病和高血压相关的相关性。
在常规体检中，应评估睡眠的数量和质量，并努力促进最佳睡眠和睡眠健康。旨在测试肥胖、精神困扰或各种慢性疾病治疗方法的持续研究也应考虑评估这些治疗方法对睡眠健康的影响。
