Smolensky Michael H, Hermida Ramón C, Castriotta Richard J, Geng Yong-Jian
Department of Biomedical Engineering, Cockell School of Engineering, The University of Texas at Austin, Austin, TX 78712, USA.
Division of Cardiovascular Medicine, Department of Internal Medicine, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
J Cardiovasc Dev Dis. 2025 Mar 8;12(3):95. doi: 10.3390/jcdd12030095.
Cardiology and sleep societies recommend 7-9 h sleep/night for adults (7-8 h for seniors) and more for youngsters; nonetheless, short sleep duration (SSD) of <7 h/night is epidemic. We searched PubMed for representative investigations, including those cited by meta-analyses, that reported association between SSD and long sleep duration (LSD) of >9 h/night and blood pressure (BP) levels to assess shortcomings of their methods. Studies indicate both SSD and LSD negatively impact BP despite major deficiencies, such as (i) reliance mainly on cross-sectional rather than longitudinal protocols, (ii) inclusion of participants diagnosed with hypertension (HTN) and/or taking antihypertension medications, (iii) assessment of BP and diagnosis of HTN performed by single wake-time office measurement rather than multiple measurements performed by 24 h ambulatory BP monitoring (ABPM), and (iv) determination of SD by subjective recall, single-night polysomnography, or diary recordings rather than objective wrist actigraphy of sufficient duration. The limited number of ABPM-based studies, despite evidencing major shortcomings, particularly (i) assessment for 24 h rather than preferred ≥48 h and (ii) inclusion of subjects diagnosed with HTN and/or taking antihypertension medications, also report association between abnormal SD and elevated 24 h 'daytime'/wake-time diastolic and systolic (SBP) means plus 'nighttime'/sleep-time SBP mean and dipping-the latter two indices, in combination, the strongest predictors of major adverse cardiovascular events.
心脏病学和睡眠协会建议成年人每晚睡眠7 - 9小时（老年人为7 - 8小时），年轻人则需要更多睡眠时间；然而，每晚睡眠时间不足7小时的短睡眠时长（SSD）现象十分普遍。我们在PubMed上搜索了代表性研究，包括荟萃分析引用的那些研究，这些研究报告了SSD与每晚睡眠时间超过9小时的长睡眠时长（LSD）以及血压（BP）水平之间的关联，以评估其方法的不足之处。研究表明，SSD和LSD均对血压有负面影响，尽管存在一些重大缺陷，例如：（i）主要依赖横断面研究而非纵向研究方案；（ii）纳入了被诊断患有高血压（HTN）和/或正在服用抗高血压药物的参与者；（iii）通过单次醒时门诊测量而非24小时动态血压监测（ABPM）进行多次测量来评估血压和诊断HTN；（iv）通过主观回忆、单次夜间多导睡眠图或日记记录而非足够时长的客观手腕活动记录仪来确定睡眠时长。尽管基于ABPM的研究数量有限，且存在重大缺陷，特别是（i）评估时长为24小时而非更理想的≥48小时，以及（ii）纳入了被诊断患有HTN和/或正在服用抗高血压药物的受试者，但这些研究也报告了异常睡眠时长与24小时“白天”/醒时舒张压和收缩压（SBP）均值升高以及“夜间”/睡眠时SBP均值升高和血压波动之间的关联——后两个指标相结合是主要不良心血管事件的最强预测因素。
