Sleep and Cardiovascular Health

描述(由研究人员提供)：随着预期寿命的增加，损害老年人功能状态和生活质量的慢性并存疾病也有平行增加。越来越多的证据表明，睡眠质量和睡眠数量与心血管健康有关。大量文献表明，在以人群为基础的研究中，睡眠时间短(7小时)与心血管疾病(CVD)风险因素(包括肥胖、高血压和糖尿病)水平的增加有关。此外，有证据表明，健康状况不佳也会增加睡眠障碍的患病率。这种关系在老年人中可能尤其明显，他们往往同时承受着睡眠障碍和医学并存的负担。这项拟议的研究是唯一一项能够对这些问题进行横向(在老年人中)和前瞻性研究的能力，特别是通过检查芝加哥心脏协会研究预先汇编的队列，研究大约40年前的心血管疾病风险状况，特别是早期成人心血管疾病风险因素水平与老年人睡眠质量和睡眠障碍的关系。具体目的是：a)确定25-44岁的心血管疾病危险状态，特别是低风险(LR)与随后的睡眠质量、日间嗜睡水平以及老年(65-79岁)睡眠呼吸暂停之间的关系；b)评估从25-44岁到老年的危险因素状态的变化是否与老年人的睡眠质量、日间嗜睡、睡眠呼吸暂停、神经心理表现和心血管健康状况有关；以及c)探索当前心血管疾病危险因素、心血管疾病、睡眠质量、嗜睡、睡眠呼吸暂停、日间神经心理表现和老年其他变量之间的关系。睡眠的客观和主观测量都将与心血管疾病风险(BMI、血压、血脂、血糖、吸烟、C反应蛋白)、临床和亚临床心血管疾病(冠状动脉钙、踝臂指数)的测量一起使用，这些测量由最近资助的父母赠款(R01 HL081141；首席研究员Martha L.Daviglus)获得。1380名参与者在基线时被确定为心血管疾病的LR或不是心血管疾病的LR，他们将接受主观和客观的睡眠测量(问卷和活动记录法)。150名参与者(50名老年不会成为高风险的LR，50名成为高风险的LR，50名在基线时仍处于高风险状态的LR)将参加实验室，进行更详细的睡眠生理研究。通过利用父母资助的资源，这项辅助研究在研究25-44岁的心血管疾病风险、睡眠变量和老年人的其他特征之间的多重关系方面具有独特的地位。本研究结果对今后睡眠障碍和心血管疾病的预防和治疗具有重要的理论和实践意义。公共卫生相关性：最近的研究表明，睡眠和睡眠障碍之间有很强的联系，例如睡眠呼吸暂停与心血管健康。大量证据清楚地表明，睡眠时间短会扰乱新陈代谢和心血管功能，并与C-反应蛋白、BMI、血压、血脂、冠状动脉钙化、踝臂指数、血糖和吸烟等心血管危险因素水平升高有关。因此，对睡眠和心血管健康之间关系的更好理解将导致预防方法和治疗策略，以改善不断增长的老年人口的功能、健康和整体生活质量。

DESCRIPTION (provided by investigator): With increase in life expectancy, there has also been a parallel increase in chronic co- morbidities that impair functional status and quality of life in older age. Converging lines of evidence link sleep quality and quantity with cardiovascular health. A considerable body of literature demonstrates that short sleep duration (<7 hours) is associated with increased levels of cardiovascular disease (CVD) risk factors including obesity, hypertension, and diabetes in population-based studies. Further, evidence suggests that poor health status also increases the prevalence of sleep disorders. This relationship may be particularly prominent in older adults, who often have the burden of both sleep disturbances and medical co-morbidities. The proposed study is uniquely able to examine these matters cross-sectionally (in older people), and prospectively -- in particular the relation of early adult CVD risk factor levels to sleep quality and sleep disorders in older age by examining a pre-assembled cohort of the Chicago Heart Association Study with CVD risk status characterized approximately 40 years ago. The specific aims are to: a) determine the relationship between CVD risk status, especially low risk (LR), at ages 25-44 with subsequent sleep quality, levels of daytime sleepiness, and sleep apnea in older age (65-79); b) assess whether change in risk factor status from ages 25-44 to older age relates to sleep quality, daytime sleepiness, sleep apnea, neuropsychological performance, and cardiovascular health status in older age, and c) explore relationships among current CVD risk factors, CVD, sleep quality, sleepiness, sleep apnea, daytime neuropsychological performance, and other variables in older age. Both objective and subjective measures of sleep are to be used in conjunction with measures of CVD risk (BMI, blood pressure, lipids, glucose, smoking, C-reactive protein), clinical and subclinical CVD (coronary artery calcium, ankle brachial index), obtained by the recently funded parent grant (R01 HL081141; Principal Investigator, Martha L. Daviglus). 1,380 participants, identified at baseline as LR for CVD or not LR for CVD, are to undergo subjective and objective sleep measures (questionnaires and actigraphy). A subset of 150 participants (50 LR who do not become high risk by older age, 50 LR who became high risk, and 50 high risk at baseline who remain so in older age) are to attend the laboratory for more detailed physiological studies of sleep. By leveraging resources of the parent grant, this ancillary study is uniquely positioned to study these multiple relationships among CVD risk at ages 25-44, sleep variables, and other traits in older age. Results of this study can have important implications theoretical and practical, e.g., for prevention and treatment of sleep disorders and CVD in later life. PUBLIC HEALTH RELEVANCE: Recent studies indicate a strong link between sleep and sleep disorders, such as sleep apnea with cardiovascular health. A considerable body of evidence clearly demonstrates that short sleep duration disrupts metabolic and cardiovascular function and has been associated with increased levels of cardiovascular risk factors, such as C-reactive protein, BMI, blood pressure, lipids, coronary artery calcium, ankle brachial index, glucose, and smoking. Therefore, an improved understanding of the relationship between sleep and cardiovascular health will lead to preventive approaches and treatment strategies to improve function, health, and overall quality of life in the growing population of older adults.