Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Applied Statistics, Johannes Kepler Universität Linz, Linz, Austria.
Eur Heart J Qual Care Clin Outcomes. 2023 Nov 2;9(7):699-706. doi: 10.1093/ehjqcco/qcad043.
To examine the association of a healthy sleep pattern with the risk of recurrent cardiovascular events among patients with coronary heart disease (CHD).
This prospective cohort study included 21 193 individuals with CHD from the UK Biobank. A healthy sleep score was generated based on a combination of chronotype, sleep duration, insomnia, and excessive daytime sleepiness. Cox proportional hazards regression models were applied to estimate the associations between healthy sleep score and recurrent cardiovascular events. During a median of 11.1 years of follow up, we documented 3771 recurrent cardiovascular events, including 1634 heart failure cases and 704 stroke cases. After multivariable adjustment, including lifestyle factors, medical history, and CHD duration, sleep 7-8 h/day, never/rarely insomnia, and no frequent daytime sleepiness were each significantly associated with a 12-22% lower risk of heart failure. In addition, compared with participants who had a healthy sleep score of 0-1, the multivariable-adjusted HR (95% CI) for participants with a healthy sleep score of 4 was 0.86 (0.75, 0.99) for recurrent cardiovascular events, 0.71 (0.57, 0.89) for heart failure, and 0.72 (0.51, 1.03) for stroke.
Adherence to a healthy sleep pattern was significantly associated with a lower risk of recurrent cardiovascular events among patients with CHD, especially for heart failure. These findings indicate that healthy sleep behaviours could be beneficial in the prevention of cardiovascular event recurrence.
研究健康的睡眠模式与冠心病（CHD）患者复发性心血管事件风险之间的关系。
本前瞻性队列研究纳入了来自英国生物库的 21193 名 CHD 患者。根据时型、睡眠时间、失眠和日间嗜睡情况，综合生成健康睡眠评分。采用 Cox 比例风险回归模型评估健康睡眠评分与复发性心血管事件之间的关联。中位随访 11.1 年后，我们记录了 3771 例复发性心血管事件，包括 1634 例心力衰竭病例和 704 例中风病例。经多变量调整，包括生活方式因素、病史和 CHD 持续时间后，每天睡眠 7-8 小时、从不/很少失眠和无频繁日间嗜睡与心力衰竭风险降低 12-22%显著相关。此外，与健康睡眠评分为 0-1 的参与者相比，健康睡眠评分为 4 的参与者的复发性心血管事件、心力衰竭和中风的多变量调整 HR（95%CI）分别为 0.86（0.75，0.99）、0.71（0.57，0.89）和 0.72（0.51，1.03）。
遵循健康的睡眠模式与 CHD 患者复发性心血管事件风险降低显著相关，尤其是心力衰竭。这些发现表明健康的睡眠行为可能有益于预防心血管事件复发。
