Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA.
J Sleep Res. 2020 Dec;29(6):e12988. doi: 10.1111/jsr.12988. Epub 2020 Feb 11.
This study investigated the associations of baseline sleep onset latency, wake after sleep onset, longest wake episode, number of awakenings, sleep efficiency and sleep duration with incident hypertension during a 7-year follow-up (n = 161, 68% men) and the joint effect of insufficient sleep and obesity on incident hypertension. Sleep parameters were derived from 15-day actigraphy data. Relative risks and 95% confidence intervals were estimated using a robust Poisson regression model. Each 10-min increase in sleep onset latency was associated with an 89% higher risk of hypertension (95% confidence interval [CI] = 1.12-3.20). Each 10-min increase in longest wake episode was associated with a 23% higher risk of hypertension (95% CI = 1.01-1.50) and each 10% decrease in sleep efficiency was associated with a 50% higher risk of hypertension (95% CI = 1.02-2.22). These associations were independent of demographic and lifestyle characteristics, depressive symptoms, shift work, sleep duration and body mass index. Having <6 hr of sleep and a body mass index ≥30 kg/m increased the risk of hypertension (relative risk = 2.81; 95% CI = 1.26-6.25) compared with having ≥6 hr of sleep and a body mass index <30 after controlling for confounders. Relative excess risk due to interaction was 3.49 (95% CI = -1.69-8.68) and ratio of relative risk was 3.21 (95% CI = 0.72-14.26). These results suggest that poor sleep quality is a risk factor for hypertension. Longitudinal studies with larger sample sizes are warranted to examine the joint effect of insufficient sleep and obesity on development of hypertension.
本研究在 7 年随访期间（n=161，68%为男性），调查了基线睡眠潜伏期、睡眠后觉醒、最长觉醒时间、觉醒次数、睡眠效率和睡眠时间与高血压发病的关系，并研究了睡眠不足和肥胖对高血压发病的联合影响。睡眠参数来自 15 天的活动记录仪数据。使用稳健泊松回归模型估计相对风险和 95%置信区间。睡眠潜伏期每增加 10 分钟，高血压发病风险增加 89%（95%置信区间 [CI]：1.12-3.20）。最长觉醒时间每增加 10 分钟，高血压发病风险增加 23%（95%CI：1.01-1.50），睡眠效率每降低 10%，高血压发病风险增加 50%（95%CI：1.02-2.22）。这些关联独立于人口统计学和生活方式特征、抑郁症状、轮班工作、睡眠时间和体重指数。与睡眠时间≥6 小时且体重指数<30 相比，睡眠时间<6 小时且体重指数≥30 的人患高血压的风险更高（相对风险=2.81；95%CI：1.26-6.25），在控制混杂因素后。交互的相对超额风险为 3.49（95%CI：-1.69-8.68），相对风险比为 3.21（95%CI：0.72-14.26）。这些结果表明，较差的睡眠质量是高血压的一个危险因素。需要进行更大样本量的纵向研究，以检验睡眠不足和肥胖对高血压发展的联合影响。
