Li Xuerui, Miao Yuyang, Yang Wenzhe, Dove Abigail, Xu Weili, Zhang Qiang
Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China; Key Laboratory of Post-Neuro Injury and Regeneration in Central Nervous System, Ministry of Education, State Key Laboratory of Experimental Hematology, Tianjin Key Laboratory of Elderly Health, Tianjin, China.
School of Public Health, Tianjin Medical University, Tianjin, China.
Sleep Health. 2025 Aug 28. doi: 10.1016/j.sleh.2025.07.005.
This study aimed to investigate whether sleep patterns are associated with the accumulation of multiple chronic diseases and multimorbidity-free survival, and to explore the role of C-reactive protein in these associations.
The study included 247,751 chronic disease--free participants from the UK Biobank (mean age: 55.20 ± 8.09, 54.69% females) who were followed for up to 16 years to detect incident chronic diseases. A total of 59 chronic diseases were ascertained through information on medical records. Multimorbidity was defined as the presence of two or more chronic diseases. Sleep patterns were assessed based on duration, chronotype, insomnia, snoring, and daytime sleepiness and categorized as healthy, intermediate, or poor. Plasma C-reactive protein concentration was measured through blood samples. Data were analyzed using the linear mixed-effects models, Cox regression, Laplace regression, and mediation analysis.
During the follow-up (median: 10.34 years), 108,764 (43.90%) participants developed multimorbidity. Having a poor compared with healthy sleep pattern was related to significantly faster accumulation of chronic diseases (β = 0.081, 95% confidence interval [CI]: 0.075, 0.086). Among people with a poor sleep pattern, the hazard ratio (95% CI) of multimorbidity was 1.347 (1.304, 1.392). Further, having poor sleep pattern shortened the median multimorbidity-free survival time by 1.747 (95% CI: -1.949, -1.546) years. In mediation analysis, C-reactive protein mediated 5.24% of sleep-multimorbidity association.
Poor sleep pattern is associated with accelerated accumulation of chronic disease, increased risk of developing multimorbidity, and shortened multimorbidity-free survival time. C-reactive protein partially mediates the sleep-multimorbidity association. Our findings underscore the connection between sleep and the development of chronic disease.
本研究旨在调查睡眠模式是否与多种慢性疾病的累积及无多种慢性病生存相关，并探讨C反应蛋白在这些关联中的作用。
该研究纳入了英国生物银行的247,751名无慢性疾病参与者（平均年龄：55.20±8.09，54.69%为女性），对其进行长达16年的随访以检测新发慢性疾病。通过病历信息确定了总共59种慢性疾病。多种慢性病被定义为存在两种或更多种慢性疾病。根据睡眠时间、昼夜节律类型、失眠、打鼾和日间嗜睡情况评估睡眠模式，并分为健康、中等或不良三类。通过血样测量血浆C反应蛋白浓度。使用线性混合效应模型、Cox回归、拉普拉斯回归和中介分析对数据进行分析。
在随访期间（中位数：10.34年），108,764名（43.90%）参与者出现了多种慢性病。与健康睡眠模式相比，不良睡眠模式与慢性疾病的累积速度显著加快有关（β = 0.081，95%置信区间[CI]：0.075，0.086）。在睡眠模式不良的人群中，多种慢性病的风险比（95%CI）为1.347（1.304，1.392）。此外，不良睡眠模式使无多种慢性病生存的中位时间缩短了1.747（95%CI：-1.949，-1.546）年。在中介分析中，C反应蛋白介导了睡眠与多种慢性病关联的5.24%。
不良睡眠模式与慢性疾病的加速累积、发生多种慢性病的风险增加以及无多种慢性病生存时间缩短相关。C反应蛋白部分介导了睡眠与多种慢性病的关联。我们的研究结果强调了睡眠与慢性疾病发生之间的联系。
