快速眼动睡眠对心血管疾病发病率的影响  

Effect of rapid eye movement sleep on the incidence of cardiovascular diseases

作　　者：侯彦丽[1] 张静静[1] 李佳媚[1] 赵玉杰[1] 张小玲[1] 高雅[1] 王小闯[1] 王岗[1] Hou Yan-li;Zhang Jing-jing;Li Jia-mei;Zhao Yu-jie;Zhang Xiao-ling;Gao Ya;Wang Xiao-chang;Wang Gang(Department of Critical Care Medicine,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院重症医学科,陕西西安710004

出　　处：《中国急救医学》2019年第11期1021-1025,共5页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金(81670049,81770057);陕西省重点研发计划项目(2017SF-059)。

摘　　要：目的探讨快速眼动(rapid eye movement,REM)睡眠对心血管疾病发病率的影响.方法利用前瞻性队列研究——美国“睡眠心脏健康研究”数据库(sleep heart health study,SHHS,注册号:NCT00005275),对纳入多导睡眠图监测记录的受试者基线睡眠时间、睡眠效率及REM睡眠特征进行多元Cox回归模型分析.同时在睡眠呼吸障碍(sleep-disordered breathing,SDB)人群和非SDB人群中进行敏感性分析,来阐明REM睡眠对心血管疾病发病率的影响.结果本研究共纳入4902例受试者,随访11年后,其中有1152例受试者发生心血管疾病.经过多因素分析,发现随着REM睡眠时间延长(HR0.974,95%CI0.951~0.997,P=0.028)及REM睡眠构成比(percent of sleep time in REM sleep,REMP)增加(HR 0.990,95%CI0.980~1.000,P=0.047),心血管疾病发病率减低,差异有统计学意义.敏感性分析结果显示,在SDB人群中,这种相关性更加明显,即REM睡眠时间(HR 0.967,95%CI0.937~0.997,P=0.034)和REMP(HR0.986,95%CI0.974~0.999,P=0.039)越高,心血管疾病发生风险越低.结论在社区人群中,REM睡眠与心血管疾病发病率可能存在相关性,其中尤以SDB人群为甚.Objective To investigate the association between rapid eye movement(REM)sleep and cardiovascular diseases.Methods A prospective study was performed within the Sleep Heart Health Study(SHHS,Registration No.NCT00005275).Total sleep time,sleep efficiency,and REM sleep were measured using polysomnography.Cox proportional hazards regression models were used to estimate the association of REM sleep with cardiovascular diseases after adjusting a series of covariates.Sensitivity analysis was conducted to determine whether the relationship between REM and cardiovascular diseases exists in population with or without sleep-disordered breathing(SDB).Results A total of 4902 individuals were recruited.Over a mean follow-up period of 11.0 years,1152 individuals suffered from cardiovascular disease.The multivariate analysis demonstrated that the longer of REM sleep time(HR 0.974,95%CI 0.951-0.997,P=0.028)and the more percentage of sleep time in REM sleep(HR 0.990,95%CI 0.980-1.000,P=0.047)were significantly associated with the lower incidence of cardiovascular disease.Sensitivity analysis showed that the higher REM sleep time(HR 0.996,95%C/0.993-1.000,P=0.024)and REMP(HR 0.986,95%C/0.974-0.999,P=0.039)will lead the lower risk of cardiovascular disease in the SDB population.Conclusion The proportion of REM sleep might serve as a protective factor of cardiovascular disease in community-based population,especially those with SDB.

关 键 词：快速眼动(REM)睡眠 心血管疾病 睡眠呼吸障碍(SDB) 

分 类 号：R74[医药卫生—神经病学与精神病学]