Department of Critical Care Medicine The Second Affiliated Hospital of Xi'an Jiaotong University Shaanxi China.
Department of Clinical Research Centre The First Affiliated Hospital of Xi'an Jiaotong University Shaanxi China.
J Am Heart Assoc. 2021 Mar 16;10(6):e018385. doi: 10.1161/JAHA.120.018385. Epub 2021 Mar 5.
Background Previous studies have suggested that sleep timing is associated with cardiovascular risk factors. However, there is no evidence on the relationship between sleep timing and congestive heart failure (CHF). We aimed to examine this relationship in this study. Methods and Results We recruited 4765 participants (2207 men; mean age, 63.6±11.0 years) from the SHHS (Sleep Heart Health Study) database in this multicenter prospective cohort study. Follow-up was conducted until the first CHF diagnosis between baseline and the final censoring date. Sleep timing (bedtimes and wake-up times on weekdays and weekends) was based on a self-reported questionnaire. Cox proportional hazard models were constructed to investigate the association between sleep timing and CHF. During the mean follow-up period of 11 years, 519 cases of CHF (10.9%) were reported. The multivariable Cox proportional hazards models revealed that participants with weekday bedtimes >12:00 am (hazard ratio [HR], 1.56; 95% CI, 1.15-2.11; =0.004) and from 11:01 pm to 12:00 am (HR, 1.25; 95% CI, 1.00-1.56; =0.047) had an increased risk of CHF compared with those with bedtimes from 10:01 pm to 11:00 pm. After stratified analysis, the association was intensified in participants with a self-reported sleep duration of 6 to 8 hours. Furthermore, wake-up times >8:00 am on weekdays (HR, 1.53; 95% CI, 1.07-2.17; =0.018) were associated with a higher risk of incident CHF than wake-up times ≤6:00 am. Conclusions Delayed bedtimes (>11:00 pm) and wake-up times (>8:00 am) on weekdays were associated with an increased risk of CHF.
先前的研究表明，睡眠时间与心血管危险因素有关。然而，目前尚无睡眠时间与充血性心力衰竭（CHF）之间关系的证据。本研究旨在探讨这种关系。
我们在这项多中心前瞻性队列研究中，从 SHHS（睡眠心脏健康研究）数据库中招募了 4765 名参与者（2207 名男性；平均年龄 63.6±11.0 岁）。随访至基线和最终截止日期之间首次 CHF 诊断。睡眠时间（工作日和周末的就寝时间和起床时间）基于自我报告的问卷。构建 Cox 比例风险模型来研究睡眠时间与 CHF 之间的关系。在平均 11 年的随访期间，报告了 519 例 CHF（10.9%）。多变量 Cox 比例风险模型显示，与就寝时间>12:00 am（风险比[HR]，1.56；95%CI，1.15-2.11；=0.004）和 11:01 pm 至 12:00 am（HR，1.25；95%CI，1.00-1.56；=0.047）的参与者相比，就寝时间从 10:01 pm 到 11:00 pm 的参与者发生 CHF 的风险增加。经过分层分析，在睡眠时间为 6 至 8 小时的参与者中，这种关联得到了强化。此外，工作日起床时间>8:00 am（HR，1.53；95%CI，1.07-2.17；=0.018）与发生 CHF 的风险较高相关，而起床时间≤6:00 am。
工作日晚睡（>11:00 pm）和晚起（>8:00 am）与 CHF 风险增加有关。
