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![Bezug Wang YH, Wang J, Chen SH, et al. Assoziation von Längsmustern der gewohnheitsmäßigen Schlafdauer mit dem Risiko von kardiovaskulären Ereignissen und Gesamtmortalität. JAMA-Netzwerk geöffnet. 2020;3(5):e205246. Studienziel Um zu bestimmen, ob die Verläufe der Langzeit-Schlafdauer im Vergleich zur Einzelmessung mit dem späteren Risiko von CVEs und der Gesamtmortalität verbunden sind Entwurf Prospektive, populationsbasierte Kohortenstudie Teilnehmer 52.599 chinesische Erwachsene (76,2 % männlich, 23,8 % weiblich) ohne Vorhofflimmern, Myokardinfarkt, Schlaganfall oder Krebs. Der Mittelwert [SD] Das Ausgangsalter aller Teilnehmer betrug 52,5 Jahre [11.8] Jahre. Studienparameter bewertet Trajektorien der Schlafdauer vom 1. Januar 2006 bis zum 31. Dezember 2010 wurden identifiziert, um den …](https://natur.wiki/cache/images/SIBO-and-Anti-Inflammatories-Boswellia-Curcumin-jpg-webp-1100.webp)
Relation
Wang YH, Wang J, Chen SH, et al. Association of longitudinal patterns of habitual sleep duration with the risk of cardiovascular events and all-cause mortality.JAMA network opened. 2020;3(5):e205246.
Study objective
To determine whether long-term sleep duration trajectories are associated with subsequent risk of CVEs and all-cause mortality compared to individual measures
Draft
Prospective, population-based cohort study
Participant
52,599 Chinese adults (76.2% male, 23.8% female) without atrial fibrillation, myocardial infarction, stroke, or cancer. The mean [SD] baseline age of all participants was 52.5 [11.8] years.
Study parameters assessed
Sleep duration trajectories from January 1, 2006 to December 31, 2010 were identified to examine the association with the risk of CVEs and all-cause mortality from January 1, 2010 to December 31, 2017 were collected in 2006, 2008 and 2010. Trajectories of sleep duration for 4 years were identified using latent mixture modeling.
Subjective, habitual nighttime sleep duration was measured every two years in face-to-face interviews with the question “How many hours of sleep did you get per night on average in the last 12 months?” raised.
Primary outcome measures
All-cause mortality and first CVEs (including fatal or non-fatal CVEs, including atrial fibrillation, myocardial infarction and stroke).
Based on baseline sleep duration and patterns over time, 4 sleep trajectories were categorized as follows:
- normal stabil
- normal abnehmend
- gering ansteigend
- niedrig stabil
Key insights
Sleep duration trajectories were significantly associated with the risk of CVEs and all-cause mortality.
Compared with the normal stable group, which maintained a sleep duration of 7.0 to 8.0 hours per night for 4 years, low stable and low rising patterns were significantly associated with a higher risk of first CVEs after adjustment for potential confounders.
Adjusted hazard ratios (HRs) of CVEs for each sample were:
- niedrig ansteigend: 1,22 (95 % KI, 1,04-1,43)
- normal-abnehmend: 1,13 (95 % KI, 0,97-1,32)
- niedrig-stabil: 1,47 (95 % KI, 1,05-2,05)
Compared to volunteers in the normal-stable group, the risk of all-cause mortality was significantly higher in those with normal decreasing and less stable sleep duration patterns.
Adjusted HRs of death for each pattern were:
- normal-abnehmend: 1,34 (95 % KI, 1,15-1,57)
- niedrig ansteigend: 0,95 (95 % KI, 0,80-1,13)
- niedrig-stabil: 1,50 (95 % KI, 1,07-2,10)
Results were consistent even when potential confounding variables were excluded, including those occurring in the first 2 years of follow-up, in shift workers, in those who developed cancer during follow-up, in those with self-reported frequent snoring, or in volunteers with atrial fibrillation.
No significant interaction was observed for any of the medical comorbidities, and results were similar when stratified by baseline weight and gender.
However, when stratified by age group, the association with CVEs for the low stable (HR, 1.75; 95% CI, 1.17-1.62) and low increasing (HR, 1.28; 95% CI, 1.04-1.56) groups was found in participants younger than 65 years but not in those older than 65 years.
Participants who slept 7.0 to 8.0 hours per night had the lowest risk of all outcomes. After adjusting for potential confounders, short and long sleep durations were associated with CVEs and death.
Compared with sleeping 7.0 to less than 8.0 hours per night, the adjusted HRs for the composite endpoints were 1.24 (95% CI, 1.10-1.39), for those sleeping less than 6.0 hours per night, 1.08 (95% CI, 0.98-1.20). for those who slept 6.0 to less than 7.0 hours per night, 1.32 (95% CI, 1.21-1.44) for those who slept 8.0 to less than 9.0 hours per night, and 1.45 (95% CI, 1.13-1.87) for those who slept at least 9.0 hours per night. Results were similar for CVEs and all-cause mortality individually.
Practice implications
Sleep deprivation is a major contributor to chronic disease and early mortality. It is estimated that 50 to 70 million Americans chronically suffer from sleep and wakefulness disorders.1There is no doubt that clinicians work with patients who struggle with sleep problems. The prevalence of insomnia in primary care patients is estimated to be 69%.2
This study is the first to evaluate the association of changes in sleep patterns with cardiovascular events and mortality. The results suggest that sleep duration trajectories are clinically important variables to evaluate when assessing the risks of a first cardiovascular event and death. Because the results remained even after adjusting for a single measure of baseline sleep duration, the current research builds on a body of previous evidence showing that individual measures of sleep duration are also associated with adverse health outcomes.
Previous research has evaluated the comorbidities and mortality associated with chronic sleep deprivation. Inadequate sleep is a correlate of virtually all psychiatric disorders and is indicative of certain disorders such as depression and substance abuse. Insomnia is also associated with reduced quality of life, similar in magnitude to chronic diseases such as congestive heart failure and major depressive disorder3.4and is considered an early symptom of Alzheimer's disease, Parkinson's disease and Huntington's disease.5
Inadequate sleep is a correlate of virtually all psychiatric disorders and is indicative of certain disorders such as depression and substance abuse.
Sleeping less than 6 hours per night on average has been linked to twice the risk of blood pressure. Men who get short sleep were also four times more likely to die early. Both short sleepers and long sleepers, i.e. people who sleep more than 9 hours per night on average, have an increased risk of metabolic syndrome and diabetes.6-10
A previous study published in 2010 in the journalSleepconcluded that increased early mortality was associated with male short sleepers but not with females.9In contrast to that previous study, the current one found an increase in all-cause mortality in both male and female volunteers who had the weakly stable and normal declining sleep curves.
The current study provides clinically relevant data that may inform how clinicians assess their patients. In addition to understanding how many hours patients sleep per night on average, understanding changes in sleep patterns over time can provide a more comprehensive picture of the risk of early cardiovascular events and death.
Conducting additional research to confirm these findings and expanding the endpoints to include additional endpoints such as diabetes, hypertension, and cancer would increase our knowledge of the health effects of sleep and changes in sleep patterns over time.