Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.
Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.
J Am Coll Cardiol. 2024 Apr 30;83(17):1671-1684. doi: 10.1016/j.jacc.2024.02.040. Epub 2024 Apr 3.
Delta wave activity is a prominent feature of deep sleep, which is significantly associated with sleep quality.
The authors hypothesized that delta wave activity disruption during sleep could predict long-term cardiovascular disease (CVD) and CVD mortality risk.
The authors used a comprehensive power spectral entropy-based method to assess delta wave activity during sleep based on overnight polysomnograms in 4,058 participants in the SHHS (Sleep Heart Health Study) and 2,193 participants in the MrOS (Osteoporotic Fractures in Men Study) Sleep study.
During 11.0 ± 2.8 years of follow-up in SHHS, 729 participants had incident CVD and 192 participants died due to CVD. During 15.5 ± 4.4 years of follow-up in MrOS, 547 participants had incident CVD, and 391 died due to CVD. In multivariable Cox regression models, lower delta wave entropy during sleep was associated with higher risk of coronary heart disease (SHHS: HR: 1.46; 95% CI: 1.02-2.06; P = 0.03; MrOS: HR: 1.79; 95% CI: 1.17-2.73; P < 0.01), CVD (SHHS: HR: 1.60; 95% CI: 1.21-2.11; P < 0.01; MrOS: HR: 1.43; 95% CI: 1.00-2.05; P = 0.05), and CVD mortality (SHHS: HR: 1.94; 95% CI: 1.18-3.18; P < 0.01; MrOS: HR: 1.66; 95% CI: 1.12-2.47; P = 0.01) after adjusting for covariates. The Shapley Additive Explanations method indicates that low delta wave entropy was more predictive of coronary heart disease, CVD, and CVD mortality risks than conventional sleep parameters.
The results suggest that delta wave activity disruption during sleep may be a useful metric to identify those at increased risk for CVD and CVD mortality.
德尔塔波活动是深度睡眠的一个显著特征，与睡眠质量有显著关联。
作者假设睡眠期间的德尔塔波活动中断可能预测长期心血管疾病（CVD）和 CVD 死亡率风险。
作者使用一种综合的基于功率谱熵的方法，根据 SHHS（睡眠心脏健康研究）中的 4058 名参与者和 MrOS（男性骨质疏松性骨折研究）睡眠研究中的 2193 名参与者的整夜多导睡眠图评估睡眠期间的德尔塔波活动。
在 SHHS 的 11.0±2.8 年随访期间，729 名参与者发生了 CVD，192 名参与者死于 CVD。在 MrOS 的 15.5±4.4 年随访期间，547 名参与者发生了 CVD，391 名参与者死于 CVD。在多变量 Cox 回归模型中，睡眠期间较低的德尔塔波熵与更高的冠心病风险相关（SHHS：HR：1.46；95%CI：1.02-2.06；P=0.03；MrOS：HR：1.79；95%CI：1.17-2.73；P<0.01）、CVD（SHHS：HR：1.60；95%CI：1.21-2.11；P<0.01；MrOS：HR：1.43；95%CI：1.00-2.05；P=0.05）和 CVD 死亡率（SHHS：HR：1.94；95%CI：1.18-3.18；P<0.01；MrOS：HR：1.66；95%CI：1.12-2.47；P=0.01），调整了协变量。Shapley 加法解释方法表明，与传统的睡眠参数相比，低德尔塔波熵对冠心病、CVD 和 CVD 死亡率风险的预测更为准确。
结果表明，睡眠期间的德尔塔波活动中断可能是识别 CVD 和 CVD 死亡率风险增加的有用指标。
