METHODS: By combining the data from two prospective studies, the Paris Prospective Study III (Paris, France) and the CoLaus|PsyCoLaus study (Lausanne, Switzerland), a healthy sleep score (HSS, range 0-5) combining five sleep patterns (early chronotype, sleep duration of 7-8 h/day, never/rarely insomnia, no sleep apnoea, and no excessive daytime sleepiness) was calculated at baseline and follow-up.
RESULTS: The study sample included 11 347 CVD-free participants aged 53-64 years (44.6% women). During a median follow-up of 8.9 years [interquartile range (IQR): 8.0-10.0], 499 first CVD events occurred (339 coronary heart disease (CHD) and 175 stroke). In multivariate Cox analysis, the risk of CVD decreased by 18% [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.76-0.89] per one-point increment in the HSS. After a median follow-up of 6.0 years (IQR: 4.0-8.0) after the second follow-up, 262 first CVD events occurred including 194 CHD and 72 stroke. After adjusting for baseline HSS and covariates, the risk of CVD decreased by 16% (HR 0.84, 95% CI 0.73-0.97) per unit higher in the follow-up HSS over 2-5 years.
CONCLUSIONS: Higher HSS and HSS improvement over time are associated with a lower risk of CHD and stroke in the community.
方法:通过结合两项前瞻性研究的数据,巴黎前瞻性研究III(巴黎,法国)和CoLaus|PsyCoLaus研究(洛桑,瑞士),健康的睡眠评分(HSS,范围0-5)结合五种睡眠模式(早期时间型,睡眠时间7-8小时/天,从不/很少失眠,没有睡眠呼吸暂停,在基线和随访时计算出白天没有过度嗜睡)。
结果:研究样本包括11347名年龄在53-64岁之间的无心血管疾病参与者(44.6%为女性)。在8.9年的中位随访期间[四分位数间距(IQR):8.0-10.0],发生了499起首次CVD事件(339起冠心病(CHD)和175起卒中)。在多变量Cox分析中,HSS每增加1分,CVD风险降低18%[风险比(HR)0.82,95%置信区间(CI)0.76-0.89].第二次随访后,中位随访6.0年(IQR:4.0-8.0),发生了262次首次CVD事件,包括194次CHD和72次中风。在调整基线HSS和协变量后,在2~5年的HSS随访中,CVD风险每单位降低16%(HR0.84,95%CI0.73~0.97).
结论:随着时间的推移,较高的HSS和HSS改善与社区冠心病和卒中风险较低相关。