Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and University of Calgary, Calgary, Alberta, Canada.
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Arthritis Care Res (Hoboken). 2023 Jun;75(6):1206-1212. doi: 10.1002/acr.25017. Epub 2022 Dec 29.
Sleep deprivation has been associated with risk of autoimmune diseases. Using the Nurses' Health Study (NHS) (1986-2016) and NHSII (1989-2017) cohorts, we aimed in the present study to investigate whether sleep deprivation was associated with risk of developing systemic lupus erythematosus (SLE).
Average sleep duration in a 24-hour period was reported in the NHS (1986-2014) and NHSII (1989-2009). Lifestyle, exposure, and medical information was collected on biennial questionnaires. Adjusted Cox regression analyses modeled associations between cumulative average sleep duration (categorical variables) and incident SLE. Interactions between sleep duration and shiftwork, bodily pain (using the Short Form 36 [SF-36] questionnaire), and depression were examined.
We included 186,072 women with 187 incident SLE cases during 4,246,094 person-years of follow-up. Chronic low sleep duration (≤5 hours/night versus reference >7-8 hours) was associated with increased SLE risk (adjusted hazard ratio [HR ] 2.47 [95% confidence interval (95% CI) 1.29, 4.75]), which persisted after the analysis was lagged (4 years; HR 3.14 [95% CI 1.57, 6.29]) and adjusted for shiftwork, bodily pain, and depression (HR 2.13 [95% CI 1.11, 4.10]). We detected additive interactions between low sleep duration and high bodily pain (SF-36 score <75) with an attributable proportion (AP) of 64% (95% CI 40%, 87%) and an HR for SLE of 2.97 (95% CI 1.86, 4.75) for those with both risk factors compared to those with neither. Similarly, there was an interaction between low sleep duration and depression, with an AP of 68% (95% CI 49%, 88%) and an HR for SLE of 2.82 (95% CI 1.64, 4.85).
Chronic low sleep duration was associated with higher SLE risk, with stronger effects among those with bodily pain and depression, highlighting the potential role of adequate sleep in disease prevention.
睡眠剥夺与自身免疫性疾病的风险相关。本研究利用护士健康研究（NHS）（1986-2016 年）和 NHSII（1989-2017 年）队列，旨在调查睡眠剥夺是否与系统性红斑狼疮（SLE）发病风险相关。
NHS（1986-2014 年）和 NHSII（1989-2009 年）报告了 24 小时内的平均睡眠时间。通过两年一次的问卷收集生活方式、暴露和医疗信息。使用累积平均睡眠时间（分类变量）与 SLE 发病的调整 Cox 回归分析模型。研究了睡眠持续时间与轮班工作、身体疼痛（使用简化 36 项健康调查 [SF-36] 问卷）和抑郁之间的交互作用。
我们纳入了 186072 名女性，随访 4246094 人年，共发生 187 例 SLE 病例。慢性低睡眠持续时间（≤5 小时/夜与参考 >7-8 小时）与 SLE 风险增加相关（调整后的危险比 [HR] 2.47 [95%置信区间（95%CI）1.29, 4.75]），该结果在分析滞后（4 年；HR 3.14 [95%CI 1.57, 6.29]）和调整轮班工作、身体疼痛和抑郁后仍然存在（HR 2.13 [95%CI 1.11, 4.10]）。我们检测到低睡眠持续时间与高身体疼痛（SF-36 评分 <75）之间存在附加交互作用，归因比例（AP）为 64%（95%CI 40%，87%）， SLE 的风险比（HR）为 2.97（95%CI 1.86, 4.75），与两个危险因素均存在的人群相比，均不存在这两个危险因素的人群 HR 为 1.00。同样，低睡眠持续时间与抑郁之间存在交互作用，AP 为 68%（95%CI 49%，88%）， SLE 的 HR 为 2.82（95%CI 1.64, 4.85）。
慢性低睡眠持续时间与 SLE 风险增加相关，在身体疼痛和抑郁患者中作用更强，这突出了充足睡眠在疾病预防中的潜在作用。
