高血压患者平均每日睡眠时间与抑郁之间的U型关联：一项基于2017 - 2020年美国国家健康与营养检查调查（NHANES）的横断面研究

U-shaped association between average daily sleep duration and depression among individuals with hypertension: a cross-sectional study based on NHANES 2017-2020.

作者信息

Cai Zhimao, Ye Ye, Chen Sixia, Cai Hualang, Lin Jiashuang, Peng Hui, Yang Wei, Zeng Lingli, Li Rourou, Chen Mengjia, Chen Weifeng

机构信息

Department of General Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518000, China.

Shenzhen University Health Science Center, Shenzhen, Guangdong, 518037, China.

出版信息

BMC Psychiatry. 2025 Jul 1;25(1):608. doi: 10.1186/s12888-025-07075-w.

DOI:10.1186/s12888-025-07075-w

PMID:40597928

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12211263/

Abstract

BACKGROUND

Depression is increasingly prevalent among individuals with hypertension, contributing to the worldwide disease burden. The link between sleep and depression, while extensively studied in the general population, remains underexplored in hypertensive individuals.

METHODS

We assessed 2,912 hypertensive participants in the National Health and Nutrition Examination Surveys (NHANES) dataset (2017-2020). Average daily sleep duration was categorized < 7 h, 7-9 h, and ≥ 9 h. Depression was identified via the 9-item Patient Health Questionnaire (PHQ-9), with a cutoff score of ≥ 10.Logistic regression, curve-fitting analyses and threshold effects analyses were employed to evaluate the association between average daily sleep duration and depression after adjusting for confounding factors.

RESULTS

Compared to the reference group with average daily sleep duration of 7-9 h, both short (< 7 h) and long (≥ 9 h) sleep durations were significantly linked to depression. In the fully adjusted model, short sleepers had an OR of 1.99 (95% CI: 1.69-2.35, p < 0.0001) and long sleepers had an OR of 1.74 (95% CI: 1.12-2.71, p = 0.0404). Smooth curve fitting analysis revealed a U-shaped relationship with an inflection point at 7.29 h. Below this point, increased average daily sleep duration reduced depression risk (OR = 0.62, 95% CI: 0.54-0.69, p < 0.0001), while above it, prolonged sleep increased risk (OR = 1.30, 95% CI: 1.16-1.45, p < 0.0001).

CONCLUSIONS

Among individuals with hypertension, average daily sleep duration exhibits a U-shaped association with depression. Both insufficient and excessive average daily sleep durations are associated with a higher risk of depression. Future research should incorporate longitudinal designs to establish temporal relationships and potential causality. Future research should also include actigraphy or polysomnography for at least a subset of participants to further validate the relationship.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

抑郁症在高血压患者中越来越普遍，加重了全球疾病负担。睡眠与抑郁症之间的联系，虽然在普通人群中已得到广泛研究，但在高血压患者中仍未得到充分探索。

方法

我们评估了国家健康与营养检查调查（NHANES）数据集（2017 - 2020年）中的2912名高血压参与者。平均每日睡眠时间分为<7小时、7 - 9小时和≥9小时。通过9项患者健康问卷（PHQ - 9）确定抑郁症，临界值分数≥10分。采用逻辑回归、曲线拟合分析和阈值效应分析来评估调整混杂因素后平均每日睡眠时间与抑郁症之间的关联。

结果

与平均每日睡眠时间为7 - 9小时的参照组相比，睡眠时间短（<7小时）和长（≥9小时）均与抑郁症显著相关。在完全调整模型中，睡眠短者的比值比为1.99（95%置信区间：1.69 - 2.35，p < 0.0001），睡眠长者的比值比为1.74（95%置信区间：1.12 - 2.71，p = 0.0404）。平滑曲线拟合分析显示呈U形关系，拐点在7.29小时。低于该点，平均每日睡眠时间增加会降低抑郁症风险（比值比 = 0.62，95%置信区间：0.54 - 0.69，p < 0.0001），而高于该点，睡眠时间延长会增加风险（比值比 = 1.30，95%置信区间：1.16 - 1.45，p < 0.0001）。