Taporoski Tâmara P, Beijamini Felipe, Alexandria Shaina J, Aaby David, Krieger Jose E, von Schantz Malcolm, Pereira Alexandre C, Knutson Kristen L
Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA.
Sleep. 2025 Mar 11;48(3). doi: 10.1093/sleep/zsae242.
Sleep characteristics are associated with cardiovascular disease (CVD) risk and both sleep and CVD risk vary by gender. Our objective was to examine associations between polysomnographic sleep characteristics and CVD risk after excluding moderate-severe sleep apnea, and whether gender modifies these associations.
This was a cross-sectional study with at-home polysomnography in adults in Brazil (n = 1102 participants with apnea-hypopnea index (AHI) <15 events/hour). Primary exposures were N3, REM, wake after sleep onset (WASO), arousal index, and AHI, and outcomes were blood pressure (BP) and lipid levels.
Associations between sleep and BP varied by gender. In women, more N3 was associated with lower systolic BP (-0.40 mmHg per 10 minutes, 95% CI: -0.71, -0.09), lower diastolic BP (-0.29 mmHg per 10 minutes, 95% CI: -0.50, -0.07), and lower odds of hypertension (OR 0.94, 95% CI: 0.89, 0.98). In men, more WASO was associated with higher systolic BP (0.41 mmHg per 10 minutes, 95% CI: 0.08, 0.74) and higher odds of hypertension (OR 1.07, 95% CI: 1.01, 1.14). No interactions by gender were observed for lipids. More WASO was associated with lower total cholesterol (-0.71 per 10 minutes, 95% CI: -1.37, -0.05). Higher AHI was associated with higher total cholesterol (+0.97 per event/hour, 95% CI: 0.24, 1.70) and higher LDL (+0.84 per event/hour, 95% CI: 0.04, 1.64).
N3 is more strongly associated with BP in women, which is consistent with other studies demonstrating gender differences in BP control and CVD risk and adds a novel risk factor. Longitudinal and interventional studies are required to determine whether changes in N3 result in BP changes.
睡眠特征与心血管疾病（CVD）风险相关，且睡眠和CVD风险均因性别而异。我们的目的是在排除中度至重度睡眠呼吸暂停后，研究多导睡眠图睡眠特征与CVD风险之间的关联，以及性别是否会改变这些关联。
这是一项在巴西成年人中进行的横断面研究，采用家庭多导睡眠图（n = 1102名呼吸暂停低通气指数（AHI）<15次/小时的参与者）。主要暴露因素为N3、快速眼动（REM）、睡眠后觉醒（WASO）、觉醒指数和AHI，结局指标为血压（BP）和血脂水平。
睡眠与血压之间的关联因性别而异。在女性中，更多的N3与较低的收缩压（每10分钟-0.40 mmHg，95%可信区间：-0.71，-0.09）、较低的舒张压（每10分钟-0.29 mmHg，95%可信区间：-0.50，-0.07）以及较低的高血压几率（比值比0.94，95%可信区间：0.89，0.98）相关。在男性中，更多的WASO与较高的收缩压（每10分钟0.41 mmHg，95%可信区间：0.08，0.74）和较高的高血压几率（比值比1.07，95%可信区间：1.01，1.14）相关。未观察到血脂方面的性别交互作用。更多的WASO与较低的总胆固醇（每10分钟-0.71，95%可信区间：-1.3７，-0.05）相关。较高的AHI与较高的总胆固醇（每事件/小时+0.97，95%可信区间：0.24，1.70）和较高的低密度脂蛋白（每事件/小时+0.84，95%可信区间：0.04，1.64）相关。
N3与女性血压的关联更为密切，这与其他表明血压控制和CVD风险存在性别差异的研究一致，并增加了一个新的风险因素。需要进行纵向和干预性研究来确定N3的变化是否会导致血压变化。
