Sleep as a potential fundamental contributor to disparities in cardiovascular health.
Sleep as a potential fundamental contributor to disparities in cardiovascular health.
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DOI：
10.1146/annurev-publhealth-031914-122838
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发表时间：
2015-03-18
影响因子：
20.8
通讯作者：
Emmons KM
中科院分区：
文献类型：
--
作者：
Jackson CL;Redline S;Emmons KM
最佳睡眠是健康不可或缺的，但通常无法获得。尽管睡眠健康对公众健康有着广泛的影响，但公众对睡眠健康的认识不足，决策者、雇主、学校和其他政策和结构可能对睡眠产生不利影响的人很少考虑睡眠健康。睡眠时间和质量不足在少数民族和低收入人群中普遍存在，可能在包括心血管疾病（CVD）在内的各种健康状况的种族和社会经济地位（SES）不平等中发挥重要作用。为此，我们描述了睡眠的整体公共卫生重要性和睡眠时间的作用，以及两种最常见的疾病（睡眠呼吸暂停和失眠）作为一些慢性疾病的危险因素。然后，我们专注于睡眠和CVD差异之间的潜在联系。作为国家癌症研究所人口健康和健康差异中心的一部分，为分析人口健康和健康差异而开发的多层次模型作为我们的概念框架。它基于这样的概念，即个人行为，如睡眠，受到个人及其整个生命周期的物理和社会环境之间复杂而动态的相互关系的影响。使用这个模型，我们描述了导致睡眠不足和昼夜节律失调的可修改因素，提出了在各个部门（例如社区，学校，工作场所）的潜在干预措施，以解决导致差异的社会结构，并通过建议未来睡眠研究的关键领域得出结论。我们最终认为，将睡眠纳入公共卫生研究将发现新的方法来缩小健康差距的差距，如心血管疾病。
Optimal sleep is integral to health but is commonly not obtained. Despite its wide ranging public health impact, sleep health is under-appreciated by the general public and is only rarely considered by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. Inadequate sleep duration and quality are prevalent in minority and low-income populations and may play a fundamental role in racial and socioeconomic status (SES) inequities for a wide range of health conditions including cardiovascular disease (CVD).The goal of this review is to examine the relationship between sleep and CVD health disparities. To this end, we describe the overall public health importance of sleep and the role of sleep duration as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We then focus on the potential link between sleep and CVD disparities. A multilevel model developed for the analysis of population health and health disparities as a part of the National Cancer Institute’s Centers on Population Health and Health Disparities served as our conceptual framework. It is based on the notion that individual behaviors, like sleep, are influenced by complex and dynamic interrelations among the individual and his or her physical and social environments across the lifespan. Using this model, we describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g. neighborhoods, schools, workplaces) that address social structures that contribute to disparities, and conclude by recommending critical areas for future sleep research. We ultimately suggest that integrating sleep into public health research will identify novel approaches for closing the gap in health disparities, such as CVD.