Sleep duration and risk of ischemic stroke in postmenopausal women.
Sleep duration and risk of ischemic stroke in postmenopausal women.
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DOI：
10.1161/strokeaha.108.521773
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发表时间：
2008-12
期刊：
影响因子：
8.3
通讯作者：
Stefanick ML
中科院分区：
文献类型：
--
作者：
Chen JC;Brunner RL;Ren H;Wassertheil-Smoller S;Larson JC;Levine DW;Allison M;Naughton MJ;Stefanick ML
许多研究表明，睡眠时间和死亡率之间存在U型关系，但将心血管疾病（CVD）与习惯性睡眠模式联系起来的流行病学证据有限且混合。我们对妇女健康倡议观察性研究队列中的93175名老年妇女（年龄50-79岁）进行了一项前瞻性研究，以检查与自我报告的睡眠时间相关的缺血性卒中风险。考克斯模型用于研究假定的相关性，调整多种社会人口学和生活方式因素、抑郁、打鼾、嗜睡症状和其他CVD相关临床特征。基线时，8.3%的受试者报告的睡眠持续时间≤ 5小时/晚，4.6%的受试者报告的睡眠时间较长（≥ 9小时/晚）。经过平均7.5年的随访，1166例缺血性卒中发生。对于睡眠时间为6小时或更少、8小时和9小时或更长的女性，缺血性卒中的多变量校正相对风险（RR; 95%置信区间）（以睡眠时间为7小时/晚作为参考）分别为1.14（0.97，1.33）、1.24（1.04，1.47）和1.70（1.32，2.21）。在基线时无心血管疾病的女性中，睡眠时间≤ 6小时/晚（RR=1.22; 1.03，1.44）的相关性略强。我们的分析还显示，长时间睡眠的不良影响可能与频繁打鼾和嗜睡相关的缺血性卒中风险增加无关（RR=1.31; 1.00，1.72）。习惯性睡眠模式是绝经后妇女缺血性卒中风险的重要神经行为决定因素。长时间睡眠（≥ 9小时/晚）的潜在神经生物学和机制介质需要进一步阐明。
Many studies have shown a U-shape association between sleep duration and mortality, but epidemiological evidence linking cardiovascular diseases (CVD) with habitual sleep patterns is limited and mixed. We conducted a prospective study on 93175 older women (aged 50–79 years) in the Women’s Health Initiative Observational Study cohort to examine the risk of ischemic stroke in relation to self-reported sleep duration. Cox models were used to investigate the putative associations, adjusting for multiple sociodemographic and lifestyle factors, depression, snoring, sleepiness symptoms, and other CVD-related clinical characteristics. At baseline, 8.3% of subjects had their reported sleep duration ≤5h/night and 4.6% with long sleep (≥9h/night). After an average of 7.5 years of follow-up, 1166 cases of ischemic stroke had occurred. Multivariable-adjusted relative risks (RR; 95% confidence intervals) for ischemic stroke (using a sleep time of 7h/night as the reference) were 1.14 (0.97, 1.33), 1.24 (1.04, 1.47) and 1.70 (1.32, 2.21) for women reporting 6 or less, 8, and 9 or more hours of sleep. A modestly stronger association with sleep duration ≤ 6h/night (RR=1.22; 1.03, 1.44) was noted among women without prevalent CVD at baseline. Our analyses also reveal that the adverse effect of long sleep is likely independent of the increased risk for ischemic stroke associated with frequent snoring and sleepiness (RR=1.31; 1.00, 1.72). Habitual sleep patterns are important neurobehavioral determinants of risk for ischemic stroke in postmenopausal women. The underlying neurobiology and mechanistic mediators for the putative adverse effect of long sleep (≥9h/night) need further elucidation.