社区居住老年人的睡眠碎片化、脑小动脉硬化和脑梗死病理
Sleep Fragmentation, Cerebral Arteriolosclerosis, and Brain Infarct Pathology in Community-Dwelling Older People.
作者信息
Lim Andrew S P, Yu Lei, Schneider Julie A, Bennett David A, Buchman Aron S
机构信息
From the Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (A.S.P.L.); Department of Neurological Sciences, Rush Alzheimer's Disease Center (L.Y., J.A.S., D.A.B., A.S.B.) and Department of Pathology (J.A.S.), Rush University, Chicago, IL.
出版信息
Stroke. 2016 Feb;47(2):516-8. doi: 10.1161/STROKEAHA.115.011608. Epub 2016 Jan 14.
BACKGROUND AND PURPOSE
Although several forms of sleep disruption are associated with stroke, few studies have examined the relationship between sleep and histopathologic measures of cerebrovascular disease. We tested the hypothesis that greater sleep fragmentation is associated with a higher burden of cerebral vessel and infarct pathology at autopsy.
METHODS
We used ordinal logistic regression models to relate sleep fragmentation measured by actigraphy to the severity of arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy, and the number of macroscopic and microscopic infarcts assessed by structured brain autopsy in 315 participants from the Rush Memory and Aging Project.
RESULTS
Greater sleep fragmentation was associated with more severe arteriolosclerosis (odds ratio, 1.27; 95% confidence interval, 1.02-1.59; P=0.03 per 1 SD greater sleep fragmentation) and more subcortical macroscopic infarcts (odds ratio, 1.31; 95% confidence interval, 1.01-1.68; P=0.04). These associations were independent of established cardiovascular risk factors and diseases, and several medical comorbidities.
CONCLUSIONS
Sleep fragmentation is associated with arteriolosclerosis and subcortical infarcts in older adults.
背景与目的
尽管多种形式的睡眠中断与中风有关，但很少有研究探讨睡眠与脑血管疾病组织病理学指标之间的关系。我们检验了这样一个假设，即睡眠碎片化程度越高，尸检时脑血管和梗死病理负担就越高。
方法
我们使用有序逻辑回归模型，将通过活动记录仪测量的睡眠碎片化程度与315名来自拉什记忆与衰老项目参与者的小动脉硬化、动脉粥样硬化和脑淀粉样血管病的严重程度，以及通过结构化脑尸检评估的宏观和微观梗死灶数量联系起来。
结果
睡眠碎片化程度越高，小动脉硬化越严重（优势比，1.27；95%置信区间，1.02 - 1.59；睡眠碎片化程度每增加1个标准差，P = 0.03），皮质下宏观梗死灶也越多（优势比，1.31；95%置信区间，1.01 - 1.68；P = 0.04）。这些关联独立于已确定的心血管危险因素和疾病以及几种合并症。
结论
睡眠碎片化与老年人的小动脉硬化和皮质下梗死有关。
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