From the Department of Psychiatry (J.-H. Lee), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea; Department of Psychiatry (J.-H. Lee, Mansur, McIntyre), University of Toronto, Ontario, Canada; Department of Psychiatry (J.-H. Lee), Kosleep Center, Seoul, Korea; Center for Cohort Studies (Park), Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea; Departments of Preventive Medicine (Ryoo, Oh, Jung), School of Medicine, Kyung Hee University, Seoul, Korea; Total Healthcare Center (Kang, Jung), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea; Mood Disorders and Psychopharmacology Unit (Mansur, Y. Lee, McIntyre), University Health Network, Toronto, Ontario, Canada; Interdisciplinary Laboratory of Clinical Neurosciences (LINC) (Mansur), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Brazil; Department of Medicine (Alfonsi), Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Institute of Medical Science (Y. Lee), University of Tornoto, Ontario, Canada; Clinical Research Coordination Center (Shin), Office of Public Relations and Collaboration, National Cancer Center, Goyang, Korea; and Department of Pharmacology (McIntyre), University of Toronto, Ontario, Canada.
Psychosom Med. 2018 Jan;80(1):78-86. doi: 10.1097/PSY.0000000000000528.
Inadequate sleep is associated with increased risk of cardiovascular events; however, the associations between sleep duration or quality and cardiac function or structure are not well understood. This cross-sectional study was conducted to investigate to what extent sleep duration and quality are associated with left ventricular (LV) diastolic dysfunction or structural deterioration.
A total of 31,598 healthy Korean adults who received echocardiography and completed the Pittsburg Sleep Quality Index were enrolled in this study. Participants were stratified into three groups by self-reported sleep duration (i.e., <7, 7-9, >9 hours) and into two groups by subjective sleep quality. Sleep duration was also assessed as a continuous variable. The odds ratios for impaired LV diastolic function, increased relative wall thickness, and LV hypertrophy (LVH) were compared between groups using multivariable logistic regression analyses.
After adjustment for confounding variables (e.g., age, smoking, body mass index), there was a statistically significant association between short sleep duration (<7 hours) and greater LVH (fully adjusted odds ratio = 1.32 [95% confidence interval {CI} = 1.02-1.73]). Short sleep duration was also significantly associated with greater LVH (0.87 per hour [95% CI = 0.78-0.98]) and increased relative wall thickness (0.92 [95% CI = 0.86-0.99]), but there was no significant association between sleep and LV diastolic function. Among individuals with normal sleep duration, poor quality of sleep was not associated with adverse cardiac measures.
These results indicate that short sleep duration (<7 hours) is associated with unfavorable LV structural characteristics. The association of insufficient sleep with adverse cardiovascular health outcomes may be mediated in part by adverse changes in cardiac structure and function.
睡眠不足与心血管事件风险增加相关；然而，睡眠时长或质量与心脏功能或结构之间的关联尚未得到充分理解。本横断面研究旨在探讨睡眠时长和质量与左心室（LV）舒张功能障碍或结构恶化之间的关联程度。
本研究共纳入 31598 名接受超声心动图检查并完成匹兹堡睡眠质量指数评估的健康韩国成年人。参与者根据自我报告的睡眠时长（<7、7-9、>9 小时）分为三组，并根据主观睡眠质量分为两组。睡眠时长也被评估为连续变量。使用多变量逻辑回归分析比较各组之间 LV 舒张功能障碍、相对室壁厚度增加和 LV 肥厚（LVH）的比值比。
在调整混杂变量（如年龄、吸烟、体重指数）后，短睡眠时长（<7 小时）与更大的 LVH 之间存在统计学显著关联（完全调整后的比值比=1.32[95%置信区间 {CI}：1.02-1.73]）。短睡眠时长与更大的 LVH（每小时 0.87[95% CI：0.78-0.98]）和相对室壁厚度增加（0.92[95% CI：0.86-0.99]）也显著相关，但睡眠与 LV 舒张功能之间没有显著关联。在睡眠正常的人群中，睡眠质量差与不良心脏指标无关。
这些结果表明，短睡眠时长（<7 小时）与不利的 LV 结构特征相关。睡眠不足与不良心血管健康结局的关联可能部分通过心脏结构和功能的不利变化来介导。
