Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Universite Paris Descartes, Paris, France.
Heart. 2019 Oct;105(19):1500-1506. doi: 10.1136/heartjnl-2018-314485. Epub 2019 Apr 8.
We aimed to investigate the association between cardiovascular health (CVH), as defined by the American Heart Association, and several sleep disturbances.
Two community-based cohorts, the Paris Prospective Study 3 (PPS3, France, n=6441) and the CoLaus study (Switzerland, n=2989) were analysed. CVH includes 7 metrics which all can be classified as poor, intermediate and ideal. Global CVH score was categorised into poor (0-2 ideal metrics), intermediate (3-4 ideal metrics) and ideal (≥5 ideal metrics). Associations between global CVH and self-reported sleep disturbances (proxy of sleep-disordered breathing [SDB], excessive daytime sleepiness, insomnia symptoms and short/long sleep duration) and SDB severity measured by polysomnography (PSG) were investigated. Adjusted OR/relative risk ratio (RRR) and 95% CIs were estimated. Subjects with previous cardiovascular disease were excluded.
Compared with poor CVH, subjects with intermediate and ideal global CVH had lower odds of self-reported SDB in both cohorts (ORs 0.55; 95% CI 0.44 to 0.68 and 0.35; 95% CI 0.22 to 0.53, respectively) and had lower SDB severity measured by PSG (RRR 0.07; 95% CI 0.02 to 0.20) in CoLaus. Subjects with intermediate and ideal global CVH had lower odds of excessive daytime sleepiness in PPS3 (ORs 0.82; 0.72 to 0.95 and 0.80; 0.82 to 1.02, respectively). No consistent associations were found between CVH and sleep duration or insomnia symptoms.
Higher levels of CVH are associated with lower odds of SDB and excessive daytime sleepiness. However, causal interpretation cannot be made and associations might be bidirectional.
我们旨在研究美国心脏协会定义的心血管健康（CVH）与多种睡眠障碍之间的关系。
分析了两个基于社区的队列，即巴黎前瞻性研究 3（PPS3，法国，n=6441）和科洛研究（瑞士，n=2989）。CVH 包括 7 项指标，所有指标都可以分为差、中、优。全球 CVH 评分分为差（0-2 个理想指标）、中（3-4 个理想指标）和优（≥5 个理想指标）。研究了全球 CVH 与自我报告的睡眠障碍（睡眠呼吸障碍[SDB]、白天嗜睡、失眠症状和短/长睡眠时间的替代指标）以及通过多导睡眠图（PSG）测量的 SDB 严重程度之间的关系。估计了调整后的比值比（OR）/相对风险比（RRR）和 95%CI。排除了有先前心血管疾病的患者。
与 CVH 较差的患者相比，两个队列中，中、优全球 CVH 患者自我报告的 SDB 发生率较低（OR 0.55；95%CI 0.44 至 0.68 和 0.35；95%CI 0.22 至 0.53），且 PSG 测量的 SDB 严重程度较低（RRR 0.07；95%CI 0.02 至 0.20）。中、优全球 CVH 患者白天嗜睡的发生率较低（PPS3 的 OR 0.82；0.72 至 0.95 和 0.80；0.82 至 1.02）。CVH 与睡眠时间或失眠症状之间没有一致的关系。
更高水平的 CVH 与 SDB 和白天嗜睡的几率较低有关。然而，不能做出因果解释，而且关联可能是双向的。
