Objective Sleep Efficiency Predicts Cardiovascular Disease in a Community Population: The Sleep Heart Health Study.
Background There was little evidence about the role of objective sleep efficiency (SE) in the incidence of major cardiovascular disease (CVD) events. The purpose of this study was to investigate the correlation between objective SE and CVD based on polysomnography. Methods and Results A total of 3810 participants from the SHHS (Sleep Heart Health Study) were selected in the current study. CVD was assessed during an almost 11-year follow-up period. The primary composite cardiovascular outcome was major adverse cardiovascular events, defined as CVD mortality, congestive heart failure, myocardial infarction, and stroke. The secondary composite cardiovascular outcome was major adverse cardiovascular event plus revascularization. Objective measured SE, including SE and wake after sleep onset, was based on in-home polysomnography records. Cox regression analysis was used to explore the association between SE and CVD. After multivariate Cox regression analysis, poor SE (<80%) was significantly associated with primary (hazard ratio [HR], 1.338; 95% CI, 1.025-1.745; P=0.032) and secondary composite cardiovascular outcomes (HR, 1.250; 95% CI, 1.027-1.521; P=0.026); it was also found to be a predictor of CVD mortality (HR, 1.887; 95% CI, 1.224-2.909; P=0.004). Moreover, wake after sleep onset of fourth quartile (>78.0 minutes) was closely correlated with primary (HR, 1.436; 95% CI, 1.066-1.934; P=0.017), secondary composite cardiovascular outcomes (HR, 1.374; 95% CI, 1.103-1.712; P=0.005), and CVD mortality (HR, 2.240; 95% CI, 1.377-3.642; P=0.001). Conclusions Poor SE and long wake after sleep onset, objectively measured by polysomnography, were associated with the increased risk of incident CVD.
['Yan|Bin|B|', 'Yang|Jian|J|', 'Zhao|Binbin|B|', 'Fan|Yajuan|Y|', 'Wang|Wei|W|', 'Ma|Xiancang|X|']
D002318:Cardiovascular Diseases D002681:China D005260:Female D000082742:Heart Disease Risk Factors D006333:Heart Failure D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D009203:Myocardial Infarction D009204:Myocardial Revascularization D017286:Polysomnography D018570:Risk Assessment D000070263:Sleep Hygiene D007319:Sleep Initiation and Maintenance Disorders D020521:Stroke
sleep efficiency cardiovascular disease major adverse cardiovascular event wake after sleep onset