Department of Neurology Yale School of Medicine New Haven CT USA.
Department of Internal Medicine Yale School of Medicine New Haven CT USA.
J Am Heart Assoc. 2024 Jan 2;13(1):e031514. doi: 10.1161/JAHA.123.031514. Epub 2023 Dec 29.
The American Heart Association's Life's Simple 7, a public health construct capturing key determinants of cardiovascular health, became the Life's Essential 8 after the addition of sleep duration. The authors tested the hypothesis that suboptimal sleep duration is associated with poorer neuroimaging brain health profiles in asymptomatic middle-aged adults.
The authors conducted a prospective magnetic resonance neuroimaging study in middle-aged individuals without stroke or dementia enrolled in the UK Biobank. Self-reported sleep duration was categorized as short (<7 hours), optimal (7-<9 hours), or long (≥9 hours). Evaluated neuroimaging markers included the presence of white matter hyperintensities (WMHs), volume of WMH, and fractional anisotropy, with the latter evaluated as the average of 48 white matter tracts. Multivariable logistic and linear regression models were used to test for an association between sleep duration and these neuroimaging markers. The authors evaluated 39 771 middle-aged individuals. Of these, 28 912 (72.7%) had optimal, 8468 (21.3%) had short, and 2391 (6%) had long sleep duration. Compared with optimal sleep, short sleep was associated with higher risk of WMH presence (odds ratio, 1.11 [95% CI, 1.05-1.18]; <0.001), larger WMH volume (beta=0.06 [95% CI, 0.04-0.08]; <0.001), and worse fractional anisotropy profiles (beta=-0.04 [95% CI, -0.06 to -0.02]; =0.001). Compared with optimal sleep, long sleep duration was associated with larger WMH volume (beta=0.04 [95% CI, 0.01-0.08]; =0.02) and worse fractional anisotropy profiles (beta=-0.06 [95% CI, -0.1 to -0.02]; =0.002), but not with WMH presence (=0.6).
Among middle-aged adults without stroke or dementia, suboptimal sleep duration is associated with poorer neuroimaging brain health profiles. Because these neuroimaging markers precede stroke and dementia by several years, these findings are consistent with other findings evaluating early interventions to improve this modifiable risk factor.
美国心脏协会的“生命的 7 要素”是一个捕捉心血管健康关键决定因素的公共卫生指标，在加入睡眠时长后，成为“生命的 8 要素”。作者验证了这样一个假设，即睡眠不足与无症状中年人群的神经影像学脑健康状况较差有关。
作者对英国生物银行中没有中风或痴呆的中年个体进行了一项前瞻性磁共振神经影像学研究。自我报告的睡眠时长分为短（<7 小时）、适中（7-<9 小时）和长（≥9 小时）。评估的神经影像学指标包括存在脑白质高信号（WMH）、WMH 体积和各向异性分数，后者是 48 个白质束的平均值。多变量逻辑回归和线性回归模型用于测试睡眠时长与这些神经影像学指标之间的关联。作者评估了 39771 名中年个体。其中，28912 人（72.7%）的睡眠时长适中，8468 人（21.3%）睡眠时长较短，2391 人（6%）睡眠时长较长。与适中的睡眠时长相比，较短的睡眠时长与更高的 WMH 存在风险相关（比值比，1.11[95%CI，1.05-1.18]；<0.001）、更大的 WMH 体积（β=0.06[95%CI，0.04-0.08]；<0.001）和较差的各向异性分数分布（β=-0.04[95%CI，-0.06 至-0.02]；=0.001）。与适中的睡眠时长相比，较长的睡眠时长与更大的 WMH 体积（β=0.04[95%CI，0.01-0.08]；=0.02）和较差的各向异性分数分布（β=-0.06[95%CI，-0.1 至-0.02]；=0.002）相关，但与 WMH 存在无关（=0.6）。
在没有中风或痴呆的中年人群中，睡眠不足与较差的神经影像学脑健康状况有关。由于这些神经影像学指标比中风和痴呆提前数年出现，因此这些发现与评估早期干预以改善这一可改变的风险因素的其他研究结果一致。
