Insomnia with objective short sleep duration and incident hypertension: the Penn State Cohort.
Insomnia with objective short sleep duration and incident hypertension: the Penn State Cohort.
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DOI：
10.1161/hypertensionaha.112.193268
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发表时间：
2012-10
期刊：
影响因子：
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通讯作者：
Bixler EO
中科院分区：
文献类型：
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作者：
Fernandez-Mendoza J;Vgontzas AN;Liao D;Shaffer ML;Vela-Bueno A;Basta M;Bixler EO
客观睡眠时间短的失眠似乎是一种生物学上更严重的疾病表型。迄今为止，还没有纵向研究使用多导睡眠图检查这种类型的失眠与高血压事件的关联。从宾夕法尼亚州立大学队列的1741名成年人的随机一般人群样本中，1395人在7.5年后随访，786人在基线时没有高血压。通过接受高血压治疗的自我报告确定高血压。慢性失眠定义为持续≥ 1年的失眠主诉，而睡眠不良定义为中度至重度睡眠困难。所有受试者均接受8小时多导睡眠图检查。睡眠呼吸障碍（SDB）定义为阻塞性呼吸暂停/低通气指数≥ 5。我们使用睡眠时间的中位数多导睡眠图百分比来定义短睡眠时间（即，< 6小时）。在我们的分析中，我们控制了性别、种族、年龄、咖啡因、吸烟、饮酒、抑郁、SDB、糖尿病、肥胖和血压。与睡眠时间≥ 6小时的正常睡眠者相比，睡眠时间短的慢性失眠者发生高血压的风险最高（OR= 3.8，95% CI=1.6-9.0）。睡眠时间短的睡眠不良者发生高血压的风险显著增加，但在控制肥胖后变得边缘显著（OR= 1.6，95%CI =0.9-2.8）。睡眠持续时间短的慢性失眠与高血压发病风险增加相关，其程度与SDB相当。失眠症患者的睡眠时间短可能是一个有用的生物学严重程度的预测指标。
Insomnia with objective short sleep duration appears to be a biologically more severe phenotype of the disorder. No longitudinal study to date has examined the association of this type of insomnia with incident hypertension using polysomnography. From a random, general population sample of 1741 adults of the Penn State Cohort, 1395 were followed-up after 7.5 years and 786 did not have hypertension at baseline. Hypertension was determined by a self-report of receiving treatment for high blood pressure. Chronic insomnia was defined as a complaint of insomnia lasting ≥ 1 year, while poor sleep was defined as moderate-to-severe sleep difficulties. All subjects underwent 8-hour polysomnography. Sleep disordered breathing (SDB) was defined as an obstructive apnea/hypopnea index ≥ 5. We used the median polysomnographic percent of sleep time to define short sleep duration (i.e., < 6 hours). We controlled for gender, race, age, caffeine, cigarettes, alcohol consumption, depression, SDB, diabetes, obesity, and blood pressure in our analyses. Compared to normal sleepers who slept ≥ 6 hours, the highest risk for incident hypertension was in chronic insomniacs with short sleep duration (OR= 3.8, 95% CI=1.6–9.0). The risk for incident hypertension in poor sleepers with short sleep duration was significantly increased but became marginally significant after controlling for obesity (OR= 1.6, 95% CI=0.9–2.8). Chronic insomnia with short sleep duration is associated with an increased risk for incident hypertension in a degree comparable to SDB. Objective short sleep duration in insomnia may serve as a useful predictor of the biological severity of the disorder.