中老年中国人的就寝时间、睡眠模式与心血管疾病事件：东风-同济队列研究。
Bedtime, sleep pattern, and incident cardiovascular disease in middle-aged and older Chinese adults: The dongfeng-tongji cohort study.
机构信息
Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Public Health, Guangzhou Medical University, Guangzhou, China.
出版信息
Sleep Med. 2023 Oct;110:82-88. doi: 10.1016/j.sleep.2023.08.002. Epub 2023 Aug 3.
OBJECTIVES
To investigate the associations of bedtime and a low-risk sleep pattern with incident cardiovascular disease (CVD).
METHODS
A total of 31,500 retirees were included from the Dongfeng-Tongji cohort in 2008-2010 and 2013. Sleep information was collected by questionnaires. CVD events were identified through the health care system until December 31, 2018. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS
During an average follow-up of 7.2 years, 8324 cases of incident CVD, including 6557 coronary heart disease (CHD) and 1767 stroke, were documented. U-shaped associations of bedtime with the risks of incident CVD and stroke were observed. Compared with bedtime between 10:01 p.m.-11:00 p.m., the HR (95% CI) for CVD was 1.10 (1.01-1.20) for ≤9:00 p.m., 1.07 (1.01-1.13) for 9:01 p.m.-10:00 p.m., and 1.32 (1.11-1.58) for >12:00 a.m., respectively, mainly driven by stroke risk (22%, 14%, and 70% higher for ≤9:00 p.m., 9:01 p.m.-10:00 p.m., and >12:00 a.m., respectively). The number of low-risk sleep factors, namely bedtime between 10:01 p.m.-12:00 a.m., sleep duration of 7-< 8 h/night, good/fair sleep quality, and midday napping ≤60 min, exhibited dose-dependent relationships with CVD, CHD, and stroke risks. Participants with 4 low-risk sleep factors had a respective 24%, 21%, and 30% lower risk of CVD, CHD, and stroke than those with 0-1 low-risk sleep factor.
CONCLUSIONS
Individuals with early or late bedtimes had a higher CVD risk, especially stroke. Having low-risk sleep habits is associated with lower CVD risks.
目的
探讨就寝时间和低风险睡眠模式与心血管疾病（CVD）事件的相关性。
方法
2008-2010 年和 2013 年，共纳入 31500 名东风-同济队列的退休人员。通过问卷收集睡眠信息。CVD 事件通过医疗保健系统确定，截至 2018 年 12 月 31 日。使用 Cox 比例风险回归模型估计风险比（HR）和 95%置信区间（CI）。
结果
在平均 7.2 年的随访期间，共记录了 8324 例 CVD 事件，包括 6557 例冠心病（CHD）和 1767 例卒中。就寝时间与 CVD 和卒中风险呈 U 型关联。与晚上 10:01-11:00 之间上床睡觉相比，晚上 9:00 前上床睡觉的 HR（95%CI）为 1.10（1.01-1.20），晚上 9:01-10:00 上床睡觉的 HR 为 1.07（1.01-1.13），晚上 12:00 后上床睡觉的 HR 为 1.32（1.11-1.58），主要由卒中风险驱动（晚上 9:00 前、晚上 9:01-10:00 以及晚上 12:00 后上床睡觉的风险分别增加 22%、14%和 70%）。低风险睡眠因素的数量，即晚上 10:01-12:00 之间上床睡觉、每晚睡眠时间 7-<8 小时、良好/一般的睡眠质量和中午小睡≤60 分钟，与 CVD、CHD 和卒中风险呈剂量依赖性关系。与低风险睡眠因素为 0-1 个的参与者相比，低风险睡眠因素为 4 个的参与者 CVD、CHD 和卒中风险分别降低 24%、21%和 30%。
结论
早睡或晚睡的人患 CVD 的风险较高，尤其是卒中。低风险的睡眠习惯与较低的 CVD 风险相关。
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