Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Columbia Veterans Affairs Health Care System, Columbia, SC, USA.
Sleep. 2023 May 10;46(5). doi: 10.1093/sleep/zsad013.
Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study.
Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses.
Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV.
To the best of the author's knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
睡眠质量差和自主神经功能紊乱都可能扰乱代谢过程。本研究在美国中年 II 期（MIDUS II）研究中，共调查了 966 名参与者，探讨了睡眠质量差和心率变异性（HRV）降低对代谢综合征的单独和综合影响。
使用匹兹堡睡眠质量指数（PSQI）评估自我报告的睡眠情况。HRV 通过 11 分钟静息心率记录获得。采用 Spearman 相关分析、一般线性回归和逻辑回归模型检验研究假设。
当以连续变量（比值比 [OR]：1.07，95%置信区间 [CI]：1.03 至 1.11）或分类变量（PSQI>5，OR：1.58，95%CI：1.19 至 2.10）评估时，PSQI 总分较差与代谢综合征有关，且在调整混杂因素后仍具有统计学意义。HRV 降低与代谢综合征之间也存在关联（ln[HF-HRV]OR：0.89，95%CI：0.80 至 0.99；ln[LF-HRV]OR：0.82，95%CI：0.72 至 0.92；ln[SDRR]OR：0.59，95%CI：0.43 至 0.79；ln[RMSSD]OR：0.75，95%CI：0.60 至 0.94）。当联合评估睡眠质量差和 HRV 降低的影响时，与正常睡眠和 HRV 相比，代谢综合征的相关性进一步增强。
据作者所知，这是第一项研究表明睡眠质量差和 HRV 降低对代谢综合征的发生有联合影响。
