Sleep and cardiovascular disease: an overview.
Sleep and cardiovascular disease: an overview.
复制标题
DOI：
10.1016/j.pcad.2008.10.004
复制
发表时间：
2009-01
影响因子：
9.1
通讯作者：
Loscalzo, Joseph
中科院分区：
文献类型：
--
作者：
Malhotra, Atul;Loscalzo, Joseph
关于睡眠和心血管疾病之间的相互作用已经取得了相当大的进展1-3。从历史上看，一些异常与睡眠呼吸暂停有关，但很可能反映了与病态肥胖有关的共病，而不是原因4。然而，最近，某些睡眠障碍已被证实会导致心血管疾病；例如，阻塞性睡眠呼吸暂停现在已被明确证实会导致全身性高血压5-10和可能的心肌梗死11，充血性心力衰竭，12中风13，14和死亡15-18。此外，心血管疾病可以扰乱睡眠，就像充血性心力衰竭患者经历阵发性夜间呼吸困难的情况一样。正如本期《PCD》杂志所讨论的，关于我们对这些现象背后的机制和联系的理解，科学正在迅速发展。睡眠不足在现代社会中非常普遍，令人信服的数据表明，在过去的几十年里，北美人的睡眠时间逐渐减少。在一些系列中，只有3%的儿童实际获得了每晚9小时的推荐睡眠时间。虽然睡眠剥夺的神经认知后果是众所周知的，也是众所周知的21，22，但新出现的数据表明，主要代谢物质23-25和心血管后果与慢性部分睡眠限制26有关。正如本期《PCD》所讨论的，在生理学研究中，睡眠不足会导致胰岛素敏感性受损27和荷尔蒙变化，从而导致饥饿感和食欲增加。事实上，流行病学研究也表明，与每晚睡眠7-8小时的人相比，短睡者的体重增加，尽管确切的机制仍不清楚24。一些数据还表明，与常规睡眠者相比，短睡者心肌梗死26的发生率增加，并且都会导致死亡28，与已知的混杂变量无关。有趣的是，长睡者(每晚9小时)似乎也有额外的并发症风险29。由于日益受到重视的严重并发症，慢性部分睡眠限制的流行很可能成为一个公共卫生问题。关于睡眠不足对健康的影响的公众教育应该是优先事项。
Considerable progress has been made regarding the interactions between sleep and cardiovascular diseases1–3. Historically, a number of abnormalities have been linked with sleep apnea but are likely a reflection of the comorbidities associated with morbid obesity rather than causal4. More recently, however, certain sleep disorders have been proven to cause cardiovascular disease; eg, obstructive sleep apnea has now been definitively proven to cause systemic hypertension5–10 and possibly myocardial infarction11, congestive heart failure, 12 stroke13, 14 and death15–18. In addition, cardiovascular diseases can disrupt sleep, as is the case in congestive heart failure patients who experience paroxysmal nocturnal dyspnea from Cheyne Stokes breathing19. As is discussed in this issue of PCD, the science is rapidly evolving regarding our understanding of the mechanisms underlying and linking these phenomena.Sleep deprivation is exceedingly common in modern society with compelling data suggesting progressive reductions in sleep duration for North Americans over the past several decades. In some series, only 3% of children were actually acquiring the recommended 9 hours of sleep per night20. Although the neurocognitive consequences of sleep deprivation are well known and well established21, 22, emerging data suggest major metabolic23–25 and cardiovascular consequences to chronic partial sleep restriction26. As discussed in this issue of PCD, sleep deprivation in physiological studies can induce impairments in insulin sensitivity27 and hormonal changes that can mediate increases in hunger and appetite25. Indeed epidemiological studies have also shown increases in body weight in short sleepers as compared with those who sleep 7–8 hours per night, although the precise mechanisms remain unclear24. Some data also suggest that short sleepers have an increased incidence of myocardial infarction26 and all cause mortality28 as compared with conventional sleepers, independent of known confounding variables. Interestingly, long sleepers (> 9 hours per night) also appear to have an excess risk of complications29. The epidemic of chronic partial sleep restriction is likely to become recognized as a public health problem owing to the severe complications that are increasingly appreciated. Public education of the health effects of sleep deprivation should be a priority.
登录
查看更多内容
影响因子：
3.3
作者：
Jellinek, H;Krenn, H;Fitzgerald, RD
通讯作者：
Fitzgerald, RD
影响因子：
158.5
作者：
Kaneko, Y;Floras, JS;Bradley, TD
通讯作者：
Bradley, TD
影响因子：
39.2
作者：
Barbé, F;Mayoralas, LR;Agusti, AGN
通讯作者：
Agusti, AGN
影响因子：
37.8
作者：
Becker, HF;Jerrentrup, A;Peter, JH
通讯作者：
Peter, JH
影响因子：
37.8
作者：
Corrà, U;Pistono, M;Giannuzzi, P
通讯作者：
Giannuzzi, P