Sleep and Cardiovascular Health

描述（由研究者提供）：随着预期寿命的增加，慢性合并症也随之增加，这些合并症会损害老年人的功能状态和生活质量。越来越多的证据表明睡眠质量和睡眠时间与心血管健康有关。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）危险因素水平增加有关，包括肥胖、高血压和糖尿病。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突出，因为老年人往往同时有睡眠障碍和医疗合并症的负担。这项提议的研究是唯一能够横断面（在老年人中）检查这些问题的研究，特别是通过检查芝加哥心脏协会研究中大约40年前CVD风险状态的预装配队列，前瞻性地检查早期成人CVD风险因素水平与老年睡眠质量和睡眠障碍的关系。具体目的是：a)确定25-44岁心血管疾病风险状态，特别是低风险状态（LR）与老年（65-79岁）随后的睡眠质量、白天嗜睡水平和睡眠呼吸暂停之间的关系；b)评估25-44岁至老年危险因素状态的变化是否与老年人睡眠质量、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；c)探讨当前心血管疾病危险因素与老年人心血管疾病、睡眠质量、嗜睡、睡眠呼吸暂停、日间神经心理表现和其他变量之间的关系。客观和主观的睡眠测量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、踝肱指数）的测量一起使用，这些测量由最近资助的父母资助（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LR或非心血管疾病LR，将接受主观和客观睡眠测量（问卷调查和活动记录仪）。150名参与者（50名LR在老年时没有成为高风险，50名LR成为高风险，50名基线时的高风险在老年时仍然如此）将参加实验室进行更详细的睡眠生理学研究。通过利用父母资助的资源，这项辅助研究独特地定位于研究25-44岁心血管疾病风险、睡眠变量和老年其他特征之间的多重关系。本研究的结果可能具有重要的理论和实践意义，例如，在以后的生活中预防和治疗睡眠障碍和心血管疾病。公共卫生相关性：最近的研究表明，睡眠和睡眠障碍（如睡眠呼吸暂停）与心血管健康之间存在密切联系。大量证据清楚地表明，短睡眠时间会扰乱代谢和心血管功能，并与心血管危险因素水平的增加有关，如c反应蛋白、BMI、血压、血脂、冠状动脉钙、踝肱指数、葡萄糖和吸烟。因此，提高对睡眠和心血管健康之间关系的理解将导致预防方法和治疗策略，以改善老年人的功能、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.