Zhang Xiao, Wang Dongling, Liu Jiangang
Xiyuan Hospital, China Academy of Chinese Medical Sciences, National Center for Clinical Cardiovascular Disease of Traditional Chinese Medicine, Beijing, China.
Graduate School, China Academy of Chinese Medical Sciences, Beijing, China.
PLoS One. 2025 Jul 11;20(7):e0326499. doi: 10.1371/journal.pone.0326499. eCollection 2025.
Sleep has a significant impact on the incidence of cardiovascular diseases (CVD), but there is no comprehensive research on this topic.
Assess the association between sleep factors and the risk of cardiovascular diseases in terms of comprehensive sleep behavior.
This study included 8,075 subjects from NHANES 2017-2020, excluding those with missing sleep/CVD data. Poor sleep factors: abnormal sleep duration (<7h or>8h), trouble sleeping, snoring, snort or stop breathing, sleepy during day. Each factor was scored (0-12 total), classifying sleep patterns as healthy (0-4), intermediate (5-8) or poor (9-12). Multivariable logistic regression analyzed the association between unhealthy sleep and CVD. Weighted data were used for restricted cubic spline (RCS) plots to assess the nonlinear relationship between sleep durations, bedtime, rising time and CVD.
Adjusted models showed significant associations between poor sleep and heart failure, myocardial infarction, stroke and hypertension (p < 0.05). Daytime sleepiness also increased stroke and hypertension risks (p < 0.05). RCS plots revealed nonlinear relationships: 7-9 hours sleep/day minimized heart failure, myocardial infarction and hypertension risks; 6-8 hours/day minimized stroke risk. Bedtime showed J-shaped and U-shaped associations with myocardial infarction and hypertension.
This nationally representative survey revealed that poor sleep patterns, particularly sleep disorders, daytime sleepiness and reported breathing obstructions were significantly associated with an increased prevalence of cardiovascular diseases. Additionally, there was a nonlinear correlation between sleep duration, bedtime, rising time and the risk of developing cardiovascular diseases.
睡眠对心血管疾病(CVD)的发病率有重大影响,但对此主题尚无全面研究。
从综合睡眠行为方面评估睡眠因素与心血管疾病风险之间的关联。
本研究纳入了2017 - 2020年美国国家健康与营养检查调查(NHANES)的8075名受试者,排除睡眠/CVD数据缺失者。不良睡眠因素包括:睡眠时间异常(<7小时或>8小时)、入睡困难、打鼾、呼吸急促或呼吸暂停、白天嗜睡。对每个因素进行评分(总分0 - 12分),将睡眠模式分为健康(0 - 4分)、中等(5 - 8分)或较差(9 - 12分)。多变量逻辑回归分析不健康睡眠与CVD之间的关联。加权数据用于受限立方样条(RCS)图,以评估睡眠时间、就寝时间、起床时间与CVD之间的非线性关系。
调整后的模型显示,不良睡眠与心力衰竭、心肌梗死、中风和高血压之间存在显著关联(p < 0.05)。白天嗜睡也增加了中风和高血压风险(p < 0.05)。RCS图显示了非线性关系:每天睡眠7 - 9小时可将心力衰竭、心肌梗死和高血压风险降至最低;每天睡眠6 - 8小时可将中风风险降至最低。就寝时间与心肌梗死和高血压呈J形和U形关联。
这项具有全国代表性的调查显示,不良睡眠模式,尤其是睡眠障碍、白天嗜睡和报告的呼吸阻塞与心血管疾病患病率增加显著相关。此外,睡眠时间、就寝时间、起床时间与患心血管疾病风险之间存在非线性相关性。