Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
J Sleep Res. 2024 Feb;33(1):e14048. doi: 10.1111/jsr.14048. Epub 2023 Sep 26.
Irregular sleep and non-optimal sleep duration separately have been shown to be associated with increased disease and mortality risk. We used data from the prospective cohort Multi-Ethnic Study of Atherosclerosis sleep study (2010-2013) to investigate: do aging adults whose sleep is objectively high in regularity in timing and duration, and of sufficient duration tend to have increased survival compared with those whose sleep is lower in regularity and duration, in a diverse US sample? At baseline, sleep was measured by 7-day wrist actigraphy, concurrent with at-home polysomnography and questionnaires. Objective metrics of sleep regularity and duration from actigraphy were used for statistical clustering using sparse k-means clustering. Two sleep patterns were identified: "regular-optimal" (average duration: 7.0 ± 1.0 hr obtained regularly) and "irregular-insufficient" (duration: 5.8 ± 1.4 hr obtained with twice the irregularity). Using proportional hazard models with multivariate adjustment, we estimated all-cause mortality hazard ratios. Among 1759 participants followed for a median of 7.0 years (Q1-Q3, 6.4-7.4 years), 176 deaths were recorded. The "regular-optimal" group had a 39% lower mortality hazard than did the "irregular-insufficient" sleep group (hazard ratio [95% confidence interval]: 0.61 [0.45, 0.83]) after adjusting for socio-demographics, lifestyle, medical comorbidities and sleep disorders. In conclusion, a "regular-optimal" sleep pattern was significantly associated with a lower hazard of all-cause mortality. The regular-optimal phenotype maps behaviourally to regular bed and wake times, suggesting sleep benefits of adherence to recommended healthy sleep practices, with further potential benefits for longevity.
不规律的睡眠和非最佳的睡眠时间分别与疾病和死亡率风险的增加有关。我们使用前瞻性队列研究多民族动脉粥样硬化研究的睡眠研究（2010-2013 年）的数据来调查：在一个多样化的美国样本中，睡眠时间规律且时长充足的成年人，与睡眠时间不规律且时长不足的成年人相比，其生存时间是否会增加？在基线时，睡眠通过 7 天腕动描记术进行测量，同时进行家庭多导睡眠图和问卷调查。使用稀疏 k-均值聚类对来自腕动描记术的睡眠规律性和时长的客观指标进行统计聚类。确定了两种睡眠模式：“规律-充足”（平均时长：7.0±1.0 小时，规律获得）和“不规律-不足”（时长：5.8±1.4 小时，两次不规则获得）。使用多变量调整的比例风险模型，我们估计了全因死亡率风险比。在中位随访时间为 7.0 年（Q1-Q3，6.4-7.4 年）的 1759 名参与者中，记录了 176 例死亡。在调整社会人口统计学、生活方式、合并症和睡眠障碍后，“规律-充足”组的死亡率风险比“不规律-不足”睡眠组低 39%（风险比[95%置信区间]：0.61[0.45, 0.83]）。结论：“规律-充足”睡眠模式与全因死亡率风险降低显著相关。“规律-充足”表型在行为上与规律的上床和起床时间相对应，表明遵守推荐的健康睡眠实践具有睡眠益处，可能对长寿有进一步的潜在益处。
