Objective but Not Subjective Short Sleep Duration Associated with Increased Risk for Hypertension in Individuals with Insomnia
Objective but Not Subjective Short Sleep Duration Associated with Increased Risk for Hypertension in Individuals with Insomnia
复制标题
DOI：
10.5665/sleep.5748
复制
发表时间：
2016-05-01
期刊：
影响因子：
5.6
通讯作者：
Krystal, Andrew D.
中科院分区：
文献类型：
--
作者：
Bathgate, Christina J.;Edinger, Jack D.;Krystal, Andrew D.
研究目的：通过对总睡眠时间的客观和主观测量，探讨总睡眠时间< 6小时或总睡眠时间>= 6小时的失眠症患者高血压患病率之间的关系。方法：采用横断面观察设计，255名成年志愿者（n = 165名女性，占64.7%）符合当前失眠诊断标准（M-Age = 46.2 y, SDAge = 13.7 y），在两所大型大学医学中心参加了这项研究。收集了两晚的多导睡眠图、2万份睡眠日记、关于睡眠、医学、心理和健康史（包括是否存在高血压）的问卷。Logistic回归评估了短睡眠时间< 6小时的失眠症患者与睡眠时间>= 6小时的失眠症患者高血压的比值比，客观和主观测量。结果：与以往使用客观总睡眠时间的研究一致，与睡眠时间b> = 6小时的失眠症患者相比，失眠和短睡眠时间< 6小时的个体报告高血压为当前医学问题的风险增加了3.59%。高血压风险增加与失眠或高血压相关的主要混杂因素无关。主观确定的总睡眠时间组没有观察到明显的风险。受试者工作特征曲线分析发现，以主观总睡眠时间为基准，灵敏度和特异性的最佳平衡出现在6 h截止点，但受试者工作特征曲线下的面积准确性较低，没有很好的判别值。结论：在调整潜在混杂因素后，客观测量的短睡眠时间使报告高血压的几率增加了三倍以上；对于主观测量的睡眠时间，这种关系不显著。该研究支持了客观睡眠时间短的失眠症与合并高血压风险增加相关的新证据。
Study Objectives: To examine the relationship between hypertension prevalence in individuals with insomnia who have short total sleep duration < 6 h or sleep duration >= 6 h, using both objective and subjective measures of total sleep duration.Methods: Using a cross-sectional, observational design, 255 adult volunteers (n = 165 women; 64.7%) meeting current diagnostic criteria for insomnia disorder (M-Age = 46.2 y, SDAge = 13.7 y) participated in this study at two large university medical centers. Two nights of polysomnography, 2 w of sleep diaries, questionnaires focused on sleep, medical, psychological, and health history, including presence/absence of hypertension were collected. Logistic regressions assessed the odds ratios of hypertension among persons with insomnia with short sleep duration < 6 h compared to persons with insomnia with a sleep duration >= 6 h, measured both objectively and subjectively.Results: Consistent with previous studies using objective total sleep duration, individuals with insomnia and short sleep duration < 6 h were associated with a 3.59 increased risk of reporting hypertension as a current medical problem as compared to individuals with insomnia with sleep duration >= 6 h. Increased risk for hypertension was independent of major confounding factors frequently associated with insomnia or hypertension. No significant risk was observed using subjectively determined total sleep time groups. Receiver operating characteristic curve analysis found that the best balance of sensitivity and specificity using subjective total sleep time was at a 6-h cutoff, but the area under the receiver operating characteristic curve showed low accuracy and did not have good discriminant value.Conclusions: Objectively measured short sleep duration increased the odds of reporting hypertension more than threefold after adjusting for potential confounders; this relationship was not significant for subjectively measured sleep duration. This research supports emerging evidence that insomnia with objective short sleep duration is associated with an increased risk of comorbid hypertension.