Sleep Characteristics and White Matter Hyperintensities Among Midlife Women.
Sleep Characteristics and White Matter Hyperintensities Among Midlife Women.
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DOI：
10.1093/sleep/zsz298
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发表时间：
2019-12
期刊：
影响因子：
5.6
通讯作者：
R. Thurston;Minjie Wu;H. Aizenstein;Yuefang Chang;Emma Barinas Mitchell;C. Derby;P. Maki
中科院分区：
文献类型：
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作者：
R. Thurston;Minjie Wu;H. Aizenstein;Yuefang Chang;Emma Barinas Mitchell;C. Derby;P. Maki
睡眠障碍在中年女性中很常见。自我报告的不良睡眠特征与脑血管疾病和痴呆风险有关。然而，很少有工作考虑客观评估的睡眠特征和白色物质高信号（WMH），在大脑中的小血管疾病的标志物的关系。在122名中年女性中，我们测试了睡眠时间短或睡眠中断的女性是否会有更大的WMH，调整心血管疾病（CVD）风险因素，雌二醇和生理评估的睡眠潮热。方法：我们招募了122名无中风或痴呆病史的女性（平均年龄=58岁），她们接受了72小时的活动记录来量化睡眠，24小时的生理监测来量化潮热;磁共振成像来评估WMH;抽血，问卷调查和物理测量（血压，身高，体重）。在线性回归模型中测试腕动记录仪评估的睡眠（入睡后觉醒，总睡眠时间）和WMH之间的关联。协变量包括人口统计学、CVD危险因素（血压、血脂、糖尿病）、雌二醇、情绪和睡眠潮热。结果：在调整人口统计学、心血管危险因素和睡眠潮热后，更高的腕动记录评估的入睡后清醒与更多的WMH相关[B（SE）= 0.008（0.002），p= 0.002]。研究结果持续调整雌二醇和情绪。总睡眠时间和主观睡眠质量均与WMH无关。结论：在中年女性中，更大的腕动计评估的睡眠开始后的清醒而不是主观睡眠与更大的大脑WMH相关。睡眠不好可能与中年时的脑小血管疾病有关，这会增加大脑疾病的风险。
STUDY OBJECTIVES Sleep disturbance is common among midlife women. Poor self-reported sleep characteristics have been linked to cerebrovascular disease and dementia risk. However, little work has considered the relation of objectively-assessed sleep characteristics and white matter hyperintensities (WMH), a marker of small vessel disease in the brain. Among 122 midlife women, we tested whether women with short or disrupted sleep would have greater WMH, adjusting for cardiovascular disease (CVD) risk factors, estradiol, and physiologically-assessed sleep hot flashes. METHODS We recruited 122 women (mean age=58 years) without a history of stroke or dementia underwent 72 hours of actigraphy to quantify sleep, 24 hours of physiologic monitoring to quantify hot flashes; magnetic resonance imaging to assess WMH; phlebotomy, questionnaires, and physical measures (blood pressure, height, weight). Associations between actigraphy-assessed sleep (wake after sleep onset, total sleep time) and WMH were tested in linear regression models. Covariates included demographics, CVD risk factors (blood pressure, lipids, diabetes), estradiol, mood, and sleep hot flashes. RESULTS Greater actigraphy-assessed waking after sleep onset was associated with more WMH [B(SE)=.008 (.002), p=.002], adjusting for demographics, CVD risk factors, and sleep hot flashes. Findings persisted adjusting for estradiol and mood. Neither total sleep time nor subjective sleep quality were related to WMH. CONCLUSIONS Greater actigraphy-assessed waking after sleep onset but not subjective sleep was related to greater brain WMH among midlife women. Poor sleep may be associated with brain small vessel disease at midlife, which can increase the risk for brain disorders.