Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China.
J Glob Health. 2023 Dec 13;13:04170. doi: 10.7189/jogh.13.04170.
Unhealthy lifestyle and diet may contribute to the development of cardiovascular disease (CVD), but limited evidence exists regarding the association between sleep patterns, oxidative stress-related exposures to diet and lifestyle, and CVD risk.
We analysed data from 10 212 adults in the National Health and Nutrition Examination Survey (NHANES) database (2005-2018). Self-report questionnaires were used to collect data on sleep duration, sleepiness, and trouble sleeping, classified into three categories: healthy, intermediate, and poor sleep patterns. Healthy sleep was defined as sleeping seven to nine hours per night with no self-reported sleepiness or trouble sleeping, while intermediate and poor sleep patterns indicated one and two to three sleep problems, respectively. The oxidative balance score (OBS) was calculated based on twenty oxidative stress-related exposures to dietary and lifestyle factors, with a higher score indicating greater antioxidant exposure. Survey-based multivariable-adjusted regression analysis was conducted to examine the association of sleep patterns or OBS alone and combined with the total and specific CVD risk.
Participants with poor sleep patterns had a higher likelihood of developing CVD (odds ratio (OR) = 1.76; 95% confidence interval (CI) = 1.26-2.45, P < 0.05), while an inverse association was found between OBS and CVD risk (quartile (Q) 4 vs Q1: OR = 0.67; 95% CI = 0.47-0.94, P = 0.02, P for trend <0.05). There was an interaction between sleep patterns and OBS (P for interaction = 0.03). Participants with unhealthy (intermediate and poor) sleep patterns and pro-oxidant OBS (Q1 and Q2) were significantly associated with increased risk of total CVD (OR = 2.31; 95% CI = 1.42-3.74, P < 0.05), as well as angina and congestive heart failure, but not coronary heart disease (CHD). Stratified analysis showed that among individuals without hyperlipidaemia, participants with both unhealthy sleep patterns and pro-oxidant OBS exhibited a higher risk of CHD compared to those with healthy sleep patterns and antioxidative OBS.
Unhealthy sleep patterns and reduced oxidative balance are positively associated with an increased risk of overall and specific CVD. Interventions that target healthy sleep habits and antioxidant-rich diets and lifestyles may be important for reducing the risk of CVD.
不健康的生活方式和饮食可能导致心血管疾病（CVD）的发生，但关于睡眠模式、与氧化应激相关的饮食和生活方式暴露与 CVD 风险之间的关系，目前相关证据有限。
我们分析了来自国家健康和营养检查调查（NHANES）数据库（2005-2018 年）的 10212 名成年人的数据。使用自我报告问卷收集睡眠持续时间、嗜睡和睡眠困难的数据，分为三类：健康、中间和较差的睡眠模式。健康睡眠定义为每晚睡 7-9 小时，没有自我报告的嗜睡或睡眠困难，而中间和较差的睡眠模式则分别表示存在一个和两个至三个睡眠问题。根据 20 种与饮食和生活方式相关的氧化应激暴露因素，计算氧化平衡评分（OBS），得分越高表示抗氧化暴露量越大。进行基于调查的多变量调整回归分析，以检查单独和联合总 CVD 风险的睡眠模式或 OBS 的相关性。
较差的睡眠模式组发生 CVD 的可能性更高（优势比（OR）=1.76；95%置信区间（CI）=1.26-2.45，P<0.05），而 OBS 与 CVD 风险呈负相关（四分位（Q）4 与 Q1：OR=0.67；95%CI=0.47-0.94，P=0.02，P 趋势<0.05）。睡眠模式和 OBS 之间存在交互作用（P 交互作用=0.03）。不健康（中间和较差）睡眠模式和促氧化剂 OBS（Q1 和 Q2）的参与者发生总 CVD 的风险显著增加（OR=2.31；95%CI=1.42-3.74，P<0.05），以及心绞痛和充血性心力衰竭，但不包括冠心病（CHD）。分层分析显示，在没有高脂血症的个体中，与具有健康睡眠模式和抗氧化 OBS 的参与者相比，同时具有不健康睡眠模式和促氧化剂 OBS 的参与者发生 CHD 的风险更高。
不健康的睡眠模式和氧化平衡降低与总 CVD 和特定 CVD 风险增加呈正相关。针对健康睡眠习惯和富含抗氧化剂的饮食和生活方式的干预措施可能对降低 CVD 风险很重要。
