From the Department of Internal Medicine (Cardiovascular Medicine) (Gaffey, Walenczyk, Burg), Yale School of Medicine, New Haven; VA Connecticut Healthcare System (Gaffey, Walenczyk, Burg), West Haven, Connecticut; Department of Psychiatry and Behavioral Health (Schwartz), Renaissance School of Medicine, Stony Brook; Department of Medicine (Schwartz), Columbia University Irving Medical Center, New York, New York; Department of Psychiatry (posthumously) (Hall), University of Pittsburgh, Pittsburgh, Pennsylvania; and Department of Anesthesiology (Burg), Yale School of Medicine, New Haven, Connecticut.
Psychosom Med. 2024;86(9):740-747. doi: 10.1097/PSY.0000000000001335. Epub 2024 Sep 3.
Among younger adults, to determine the associations of actigraph- and self-reported sleep duration with arterial stiffness (AS) assessed in clinic and in ecologically valid contexts, and to examine sex-specific associations.
Healthy adults ( n = 282, median age = 29 years, 67% women) completed a state-of-the-art assessment of AS at rest (SphygmoCor; carotid femoral pulse wave velocity [cfPWV]; central augmentation index [cAIx]) and 7 days of actigraphy-assessed sleep with concurrent, momentary cAIx assessment for 36 hours (Oscar-2). Multivariable regressions were conducted on the full sample and sex-stratified to examine cross-sectional linear and quadratic associations of average sleep duration with resting PWV and cAIx, average cAIx while awake and asleep, and nocturnal cAIx dipping, adjusted for demographic and health covariates. Exploratory analyses included self-reported sleep duration with AS, and actigraphy and self-reported sleep duration with the ambulatory arterial stiffness index (AASI; Oscar-2).
Overall and by sex, associations of average sleep duration with resting cfPWV, resting cAIx, and awake cAIx were not significant. Sleep duration showed a positive, linear association with sleep cAIx in women (95% confidence interval =1.07 to 5.86, Δ R2 = 0.021). Among women, sleep duration was also inversely associated with cAIx dipping (95% confidence interval = -4.48 to -0.95, Δ R2 = 0.020). Analyses with self-reported sleep duration and AASI as alternate predictors and outcomes were not significant.
Certain sleep duration-AS associations may be sex-specific. Assessing sleep and momentary AS in ecologically valid conditions outside the research laboratory is valuable to understand these relations. Although this investigation should be replicated, findings raise the question of whether interventions to target sleep duration also reduce AS.
在年轻成年人中，确定活动记录仪和自我报告的睡眠时间与在诊所和生态有效环境中评估的动脉僵硬度（AS）之间的关联，并检查性别特异性关联。
健康成年人（n=282，中位年龄 29 岁，67%为女性）完成了最先进的 AS 评估，包括静息状态下的脉搏波速度（SphygmoCor；颈动脉-股动脉脉搏波速度 [cfPWV]；中心增强指数 [cAIx]）和 7 天的活动记录仪评估睡眠，同时在 36 小时内进行即时 cAIx 评估（Oscar-2）。在全样本和性别分层中进行多变量回归，以检查平均睡眠时间与静息 PWV 和 cAIx、清醒和睡眠时的平均 cAIx 以及夜间 cAIx 下降的横断面线性和二次关联，调整了人口统计学和健康协变量。探索性分析包括自我报告的睡眠时间与 AS、活动记录仪和自我报告的睡眠时间与动态动脉僵硬度指数（AASI；Oscar-2）的关系。
总体而言，无论性别如何，平均睡眠时间与静息 cfPWV、静息 cAIx 和清醒时 cAIx 的关联均不显著。女性的睡眠时间与睡眠时的 cAIx 呈正线性关联（95%置信区间=1.07 至 5.86，ΔR2=0.021）。在女性中，睡眠时间与 cAIx 下降也呈负相关（95%置信区间= -4.48 至 -0.95，ΔR2=0.020）。使用自我报告的睡眠时间和 AASI 作为替代预测因子和结果的分析不显著。
某些睡眠时间与 AS 的关联可能具有性别特异性。在研究实验室外的生态有效环境中评估睡眠和即时 AS 对于理解这些关系非常有价值。尽管需要对这一研究进行重复，但研究结果提出了一个问题，即是否通过干预来延长睡眠时间也能降低 AS。
