近期，《美國心臟病學會雜誌》（JACC）發表一項前瞻性研究“Sleep Irregularity and Risk of Cardiovascular Events”首次證實：對中老年人來說，睡眠模式不規律，一週內的睡眠時長和入睡時間點波動過大，與五年內的心血管疾病風險翻倍有關！
具體來說，睡眠時長和入睡時間點波動過大，是指一週內這兩個指標的標準差數值，如果數值分別超過120和90分鐘，就與心血管疾病的發病和死亡風險翻倍有關。
所以督促老人們規律作息還是至關重要的。
這項研究旨在研究睡眠規律與心血管疾病（CVD）風險之間的關係。
研究分析的數據，來自經典的動脈粥樣硬化多種族研究（MESA）隊列，涉及近2000名受試者，他們的平均年齡達到了79歲。而為了獲得準確的睡眠時長和入睡時間點，研究可以說是三管齊下。
本研究採用了三種數據採集方法，第一個傳統的調查問卷，另一個是睡眠監測腕錶（要求受試者們連戴7天，從而獲取一週內每晚的睡眠時長和入睡時間點），第三是經典的一夜多導睡眠監測。
獲得數據後，研究團隊分別獨立計算睡眠時長和入睡時間點的標準差。這些數據於2010-2013年開展，到現在中位隨訪期也達到了4.9年，足夠開展中短期的風險分析了。
睡眠時長標準差低於60分鐘，入睡時間點標準差低於30分鐘，在分析中被認為是睡眠最規律的人群，太高的就列為不規律人群。
結果顯示，在平均4.9年的隨訪中，有111位參與者發生了CVD事件。本研究結果提示，不規律的睡眠時間和時間安排可能是CVD的新危險因素，與傳統CVD危險因素以及睡眠數量和/或質量無關。
原文
Sleep Irregularity and Risk of Cardiovascular Events
Huang T, Mariani S, Redline S. Sleep Irregularity and Risk of Cardiovascular Events [J]. Journal of the American College of Cardiology, 2020, 75(9): 991.
Abstract
Background The cardiovascular system exhibits strong circadian rhythms to maintain normal functioning. Irregular sleep schedules, characterized by high day-to-day variability in sleep duration or timing, represent possibly milder but much more common and chronic disruption of circadian rhythms in the general population than shift work.
Objectives This study aimed to prospectively examine the association between sleep regularity and risk of cardiovascular disease (CVD).
Methods In MESA (Multi-Ethnic Study of Atherosclerosis), 1,992 participants free of CVD completed 7-day wrist actigraphy for sleep assessment from 2010 to 2013 and were prospectively followed through 2016. The study assessed sleep regularity using the SD of actigraphy-measured sleep duration and sleep-onset timing across 7 days. Incident CVD included nonfatal and fatal cardiovascular events. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for incident CVD according to SD of sleep duration and timing, adjusted for traditional CVD risk factors (including CVD biomarkers) and other sleep-related factors (including average sleep duration).
Results During a median follow-up of 4.9 years, 111 participants developed CVD events. The multivariable-adjusted HRs (95% confidence intervals) for CVD across categories of sleep duration SD were 1.00 (reference) for ≤60 min, 1.09 (0.62 to 1.92) for 61 to 90 min, 1.59 (0.91 to 2.76) for 91 to 120 min, and 2.14 (1.24 to 3.68) for >120 min (p trend = 0.002). Similarly, compared with participants with a sleep timing SD ≤30 min, the HRs (95% confidence intervals) for CVD were 1.16 (0.64 to 2.13) for 31 to 60 min, 1.52 (0.81 to 2.88) for 61 to 90 min, and 2.11 (1.13 to 3.91) for >90 min (p trend = 0.002). Exclusion of current shift workers yielded similar results.
Conclusions Irregular sleep duration and timing may be novel risk factors for CVD, independent of traditional CVD risk factors and sleep quantity and/or quality.
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