近期，《美国心脏病学会杂志》（JACC）发表一项前瞻性研究“Sleep Irregularity and Risk of Cardiovascular Events”首次证实：对中老年人来说，睡眠模式不规律，一周内的睡眠时长和入睡时间点波动过大，与五年内的心血管疾病风险翻倍有关！
具体来说，睡眠时长和入睡时间点波动过大，是指一周内这两个指标的标准差数值，如果数值分别超过120和90分钟，就与心血管疾病的发病和死亡风险翻倍有关。
所以督促老人们规律作息还是至关重要的。
这项研究旨在研究睡眠规律与心血管疾病（CVD）风险之间的关系。
研究分析的数据，来自经典的动脉粥样硬化多种族研究（MESA）队列，涉及近2000名受试者，他们的平均年龄达到了79岁。而为了获得准确的睡眠时长和入睡时间点，研究可以说是三管齐下。
本研究采用了三种数据采集方法，第一个传统的调查问卷，另一个是睡眠监测腕表（要求受试者们连戴7天，从而获取一周内每晚的睡眠时长和入睡时间点），第三是经典的一夜多导睡眠监测。
获得数据后，研究团队分别独立计算睡眠时长和入睡时间点的标准差。这些数据于2010-2013年开展，到现在中位随访期也达到了4.9年，足够开展中短期的风险分析了。
睡眠时长标准差低于60分钟，入睡时间点标准差低于30分钟，在分析中被认为是睡眠最规律的人群，太高的就列为不规律人群。
结果显示，在平均4.9年的随访中，有111位参与者发生了CVD事件。本研究结果提示，不规律的睡眠时间和时间安排可能是CVD的新危险因素，与传统CVD危险因素以及睡眠数量和/或质量无关。
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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