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Ma M, Fan Y, Peng Y, Ma Q, Jia M, Qi Z, Yang J, Wang W, Ma X, Yan B. Association of sleep timing with all-cause and cardiovascular mortality: the Sleep Heart Health Study and the Osteoporotic Fractures in Men Study. J Clin Sleep Med 2024; 20:545-553. [PMID: 38561941 PMCID: PMC10985312 DOI: 10.5664/jcsm.10926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 04/04/2024]
Abstract
STUDY OBJECTIVES Previous studies have highlighted the importance of sleep patterns for human health. This study aimed to investigate the association of sleep timing with all-cause and cardiovascular disease mortality. METHODS Participants were screened from two cohort studies: the Sleep Heart Health Study (SHHS; n = 4,824) and the Osteoporotic Fractures in Men Study (n = 2,658). Sleep timing, including bedtime and wake-up time, was obtained from sleep habit questionnaires at baseline. The sleep midpoint was defined as the halfway point between the bedtime and wake-up time. Restricted cubic splines and Cox proportional hazards regression analyses were used to examine the association between sleep timing and mortality. RESULTS We observed a U-shaped association between bedtime and all-cause mortality in both the SHHS and Osteoporotic Fractures in Men Study groups. Specifically, bedtime at 11:00 pm and waking up at 7:00 am was the nadir for all-cause and cardiovascular disease mortality risks. Individuals with late bedtime (> 12:00 am) had an increased risk of all-cause mortality in SHHS (hazard ratio 1.53, 95% confidence interval 1.28-1.84) and Osteoporotic Fractures in Men Study (hazard ratio 1.27, 95% confidence interval 1.01-1.58). In the SHHS, late wake-up time (> 8:00 am) was associated with increased all-cause mortality (hazard ratio 1.39, 95% confidence interval 1.13-1.72). No significant association was found between wake-up time and cardiovascular disease mortality. Delaying sleep midpoint (> 4:00 am) was also significantly associated with all-cause mortality in the SHHS and Osteoporotic Fractures in Men Study. CONCLUSIONS Sleep timing is associated with all-cause and cardiovascular disease mortality. Our findings highlight the importance of appropriate sleep timing in reducing mortality risk. CITATION Ma M, Fan Y, Peng Y, et al. Association of sleep timing with all-cause and cardiovascular mortality: the Sleep Heart Health Study and the Osteoporotic Fractures in Men Study. J Clin Sleep Med. 2024;20(4):545-553.
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Affiliation(s)
- Mingfang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yajuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yuan Peng
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qingyan Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Min Jia
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhiyang Qi
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jian Yang
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Bin Yan
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Chen C, Zhang B, Huang J. Objective sleep characteristics and hypertension: a community-based cohort study. Front Cardiovasc Med 2024; 11:1336613. [PMID: 38504713 PMCID: PMC10948550 DOI: 10.3389/fcvm.2024.1336613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024] Open
Abstract
Objective The link between sleep quality and hypertension risk is well-established. However, research on the specific dose-relationship between objective sleep characteristics and hypertension incidence remains limited. This study aims to explore the dose-relationship association between objective sleep characteristics and hypertension incidence. Methods A community-based prospective cohort study design was employed using data from the Sleep Heart Health Study (SHHS). A total of 2,460 individuals were included in the study, of which 780 had hypertension. Baseline personal characteristics and medical history were collected. Objective sleep characteristics were obtained through polysomnography (PSG). Multivariate logistic regression models were utilized for analysis. Restricted cubic splines (RCS) were used to examine dose-relationship associations. Results After adjusting for covariates, the percentage of total sleep duration in stage 2 (N2%) was positively associated with hypertension incidence, while the N3% was negatively associated with hypertension incidence Odds ratio (OR) = 1.009, 95% confidence interval (CI) [1.001, 1.018], P = 0.037; OR = 0.987, 95% CI: [0.979, 0.995], P = 0.028, respectively. For every 10% increase in N2 sleep, the risk of developing hypertension increases by 9%, while a 3% decrease in N3 sleep corresponds to a 0.1% increase in the incidence of hypertension. In the subgroup of non-depression, a positive association between N2% and hypertension was significant statistically (OR = 1.012, 95%CI, 1.002, 1.021, P = 0.013, Pinteraction = 0.013). RCS demonstrated that the risk of developing hypertension was lower when N2% ranged from 38% to 58% and rapidly increased thereafter (P = 0.002, non-linear P = 0.040). The lowest risk for hypertension incidence risk of N3% occurring at 25%, and a significant increase below 15% or above 40% (P = 0.001, non-linear P = 0.008). Conclusions There's a negative association between N3% and the incidence of hypertension, and a positive association between N2% and the incidence of hypertension, particularly among non-depression individuals. These associations exhibit strong non-linear dose-response relationships.
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Affiliation(s)
- Chunyong Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Bo Zhang
- Intensive Care Medicine Department, National Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Jingjing Huang
- Cardiac Intensive Care Unit, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Yilmaz A, Li P, Kalsbeek A, Buijs RM, Hu K. Differential Fractal and Circadian Patterns in Motor Activity in Spontaneously Hypertensive Rats at the Stage of Prehypertension. Adv Biol (Weinh) 2023; 7:e2200324. [PMID: 37017509 DOI: 10.1002/adbi.202200324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/03/2023] [Indexed: 04/06/2023]
Abstract
One possible pathological mechanism underlying hypertension and its related health consequences is dysfunction of the circadian system-a network of coupled circadian clocks that generates and orchestrates rhythms of ≈24 h in behavior and physiology. To better understand the role of circadian function during the development of hypertension, circadian regulation of motor activity is investigated in spontaneously hypertensive rats (SHRs) before the onset of hypertension and in their age-matched controls-Wistar Kyoto rats (WKYs). Two complementary properties in locomotor activity fluctuations are examined to assessthe multiscale regulatory function of the circadian control network: 1) rhythmicity at ≈24 h and 2) fractal patterns-similar temporal correlation at different time scales (≈0.5-8 h). Compared to WKYs, SHRs have more stable and less fragmented circadian activity rhythms but the changes in the rhythms (e.g., period and amplitude) from constant dark to light conditions are reduced or opposite. SHRs also have altered fractal activity patterns, displaying activity fluctuations with excessive regularity at small timescales that are linked to rigid physiological states. These different rhythmicity/fractal patterns and their different responses to light in SHRs indicate that an altered circadian function may be involved in the development of hypertension.
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Affiliation(s)
- Ajda Yilmaz
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, 1105BA, The Netherlands
| | - Peng Li
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Andries Kalsbeek
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, 1105BA, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, 1105AZ, The Netherlands
- Laboratory of Endocrinology, Amsterdam Gastroenterology, Endocrinology Metabolism (AGEM), Amsterdam UMC, Amsterdam, 1105AZ, Netherlands
| | - Ruud M Buijs
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, 1105BA, The Netherlands
- Department of Cell Biology and Physiology, Instituto Investigaciones Biomedicas, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - Kun Hu
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
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Shi JH, Ding J, Cheng H, Fang H, Zhu J. Effect of Sleep Duration on Blood Pressure in Patients with SARS-CoV-2 Infection and Hypertensive Urgencies in Shanghai Fangcang Shelter Hospital. Infect Drug Resist 2023; 16:3981-3988. [PMID: 37366502 PMCID: PMC10290844 DOI: 10.2147/idr.s420182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023] Open
Abstract
Objective To evaluate the effect of sleep duration on blood pressure in patients with hypertension urgencies combined with SARS-CoV-2 infection in a Fangcang shelter hospital. Methods From April 10, 2020 to May 20, 2022, we statistically analyzed the blood pressure and sleep conditions of 52 patients with combined hypertension urgencies and SARS-CoV-2 infection admitted in Shanghai National Convention and Exhibition Center Fangcang shelter hospital. They were divided into the short-term (daily sleep duration: <7 h) and normal sleep group (7-9 h). We performed a comparison of the control effects of basic antihypertensive drugs. Additionally, patients in the short-term sleep group underwent drug therapy for sleep regulation and continuous monitoring of blood pressure. Results Among these patients, the blood pressure was higher in the short-term sleep group than that of the normal sleep group, and also more difficult to control (p <0.05). Furthermore, the blood pressure of the patients in the short-term sleep group was more easily controlled after treatment with drugs for sleep regulation and basic antihypertensive drugs (p <0.05). Conclusion The blood pressure level in patients with combined SARS-CoV-2 infection and hypertension urgencies was higher in those with a shorter duration of daily sleep, and also more difficult to control in Fangcang shelter hospital. Drug therapy for sleep regulation should be administered early to obtain sufficient blood pressure control effects.
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Affiliation(s)
- Jin-Hu Shi
- Department of Cardiology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Jian Ding
- Department of Disinfection and Supply, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Hu Cheng
- Department of Cardiology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Huang Fang
- Department of Neurology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, Hubei Province, People’s Republic of China
| | - Jian Zhu
- Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
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You J, Gao J, He M, Wu J, Ye J. Relative spectral power quantifying the distribution of intermittent hypoxemia in obstructive sleep apnea is strongly associated with hypertension. Sleep Med 2023; 103:165-172. [PMID: 36805916 DOI: 10.1016/j.sleep.2023.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
STUDY OBJECTIVES To investigate the association between the periodicity of distribution of intermittent hypoxemia (IH) and hypertension in adults with obstructive sleep apnea (OSA) and search for an index to quantify the association. METHODS Samples were derived from two cross-sectional studies: The Sleep Heart Health Study (SHHS) including 3991 adults with age 64.7 ± 10.9 years; and the Chinese Changgung Sleep Health Study (CSHS) including 906 adults with age 59.5 ± 12.4 years. Spectral analysis of peripheral oxygen saturation (SpO2) was performed and the relative spectral power (PFR) in the frequency band of 0.011-0.037 Hz (PFR0.011-0.037Hz) was extracted to quantify the periodic distribution of IH. Multiple logistic regression models were used to calculate the partially and fully adjusted odd ratios for PFR0.011-0.037Hz. RESULTS PFR0.011-0.037Hz was significantly higher in the hypertension group than non-hypertension group (44.4% ± 0.3% vs. 42.1% ± 0.3%, p < 0.001 in SHHS and 57.4% ± 0.7% vs. 50.5% ± 0.8%, p < 0.001 in CSHS). In the fully adjusted model, individuals in the SHHS with PFR0.011-0.037Hz in the highest quintiles had an odd ratio of 1.33 [95% confidence interval (CI) 1.06-1.67]. Similarly, the group in the CSHS with PFR0.011-0.037Hz in the highest quintile had an odd ratio of 3.08 (95% CI 1.80-5.28). CONCLUSIONS We developed an IH distribution measure which is strongly associated with hypertension independent of multiple confounding variables. The finding suggests that the periodic distribution of sleep related upper airway obstructions is an essential hypertension characterizing feature.
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Affiliation(s)
- Jingyuan You
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China; Department of Otorhinopharyngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Institute for Precision Medicine, Tsinghua University, Beijing, China
| | - Jiandong Gao
- Institute for Precision Medicine, Tsinghua University, Beijing, China; Department of Electronic Engineering, Tsinghua University, Beijing, China
| | - Mu He
- Department of Otorhinopharyngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ji Wu
- Institute for Precision Medicine, Tsinghua University, Beijing, China; Department of Electronic Engineering, Tsinghua University, Beijing, China
| | - Jingying Ye
- Department of Otorhinopharyngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Institute for Precision Medicine, Tsinghua University, Beijing, China.
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Xia N, Wang H, Chen Y, Fan XJ, Nie XH. Association Between Sleep Efficiency and Hypertension in Chinese Obstructive Sleep Apnea Patients. Nat Sci Sleep 2023; 15:79-88. [PMID: 36926203 PMCID: PMC10012910 DOI: 10.2147/nss.s396893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/26/2023] [Indexed: 03/18/2023] Open
Abstract
Objective We aimed to explore the relationship of sleep efficiency (SE) with the prevalence of hypertension in Chinese obstructive sleep apnea (OSA) patients based on polysomnography (PSG) records. Methods We studied 2360 patients with OSA and 764 primary snorers who underwent PSG in our hospital. SE was divided into three grades, including ≥85%, 80%~84.9%, and <80%. Hypertension was defined based either on direct blood pressure measurements, under anti-hypertensive treatments or on physician diagnosis. Multivariate logistic regression models were conducted to investigate the association between SE and hypertension. Results After adjusting for potential confounding factors, OSA patients with <80% SE and those with 80% to 84.9% SE were significantly associated with the prevalence of hypertension (OR = 1.248, 95% CI 1.018~1.531, P=0.033; OR = 1.380, 95% CI 1.040~1.832, P=0.026). Compared to primary snorers, OSA combined with <85% SE increased the odds of hypertension. In stratified analysis by SE, risk of hypertension only in those with <80% SE was significantly different between OSA and primary snorers. Furthermore, this relationship between reduced SE and hypertension was evident especially in female, younger ages, obese, moderate and severe OSA patients. No significant relationship between reduced SE and hypertension was found in primary snores group. Conclusion We found that poor SE was correlated with the prevalence of hypertension in Chinese OSA patients, but not in those with primary snoring. Moreover, this relationship was evident especially in female, younger ages, obese, moderate and severe OSA patients.
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Affiliation(s)
- Ning Xia
- Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hao Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yu Chen
- Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiao-Jun Fan
- Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiu-Hong Nie
- Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
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Polysomnographic Evaluation of Sleep Bruxism Intensity and Sleep Architecture in Nonapneic Hypertensives: A Prospective, Observational Study. J Clin Med 2022; 11:jcm11113113. [PMID: 35683499 PMCID: PMC9181472 DOI: 10.3390/jcm11113113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 11/24/2022] Open
Abstract
Sleep bruxism (SB) is a repetitive jaw muscle activity characterized by clenching or grinding of the teeth, which is classified under sleep-related movement disorders in the International Classification of Sleep Disorders—Third Edition. Because the potential common pathomechanism of SB and arterial hypertension is the activation of the sympathetic system as well as an increase in inflammatory factors, we aimed to examine the intensity of SB and the sleep architecture among patients with arterial hypertension. The study included a total of 91 Caucasian adult patients, among whom 31 had arterial hypertension diagnosed according to the current European Society of Cardiology/European Society of Hypertension (ESC/EHS) hypertension guidelines. The control group consisted of 61 normotensive patients. Patients with obstructive sleep apnea were excluded. A single full-night polysomnographic examination was conducted in the Sleep Laboratory, and then the results were analyzed based on the guidelines of the American Academy of Sleep Medicine. Bruxism episode index (BEI) was higher in the hypertensive group compared to normotensives. The groups also showed statistically significant differences in polysomnographic sleep indexes. Similar to BEI, arousal index, apnea–hypopnea index, and snoring were higher in hypertensives compared to normotensives. On the other hand, the mean and minimal oxygen saturation were lower in hypertensives compared to normotensives. A statistically significant positive correlation was observed between oxygen desaturation index and BEI in the hypertensive group, whereas this correlation was not statistically significant in the case of normotensives. In summary, nonapneic hypertensives had higher SB intensity, altered sleep architecture, decreased mean oxygen saturation, and increased snoring compared to normotensives. The results suggest that dental screening is necessary for patients with arterial hypertension, especially those presenting with the symptoms of SB.
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Yan B, Zhao B, Jin X, Xi W, Yang J, Yang L, Ma X. Sleep Efficiency May Predict Depression in a Large Population-Based Study. Front Psychiatry 2022; 13:838907. [PMID: 35492719 PMCID: PMC9043133 DOI: 10.3389/fpsyt.2022.838907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of our study was to investigate the effect of objective sleep characteristics on the incidence of depression. METHODS The participants of our study (1,595 men and 1,780 women with 63.1 ± 10.7 years) were selected from the Sleep Heart Health Study (SHHS) datasets. Depression was defined as the first occurrence between SHHS visit 1 and visit 2. Objective sleep characteristics, including sleep efficiency (SE), wake after sleep onset (WASO), sleep fragmentation index (SFI) and arousal index (ArI), were monitored by polysomnography. Multivariable logistic regression was used to explore the relationship between sleep characteristics and depression. RESULTS A total of 248 patients with depression (7.3%) were observed between SHHS visits 1 and 2. After adjusting for covariates, SE (odds ratio [OR], 0.891; 95% confidence interval [CI] 0.811-0.978; P = 0.016) and WASO (OR, 1.021; 95% CI 1.002-1.039; P = 0.026) were associated with the incidence of depression. Moreover, the relationship between SE and depression was more pronounced in men (OR, 0.820; 95% CI 0.711-0.946; P = 0.007) than in women (OR, 0.950; 95% CI 0.838-1.078; P = 0.429) in subgroup analysis (P interaction < 0.05). CONCLUSIONS SE and WASO may be markers for the incidence of depression. The association between SE and depression was intensified in men.
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Affiliation(s)
- Bin Yan
- Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Binbin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoying Jin
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenyu Xi
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jian Yang
- Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lihong Yang
- Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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