News Release 2-Mar-2020

Inconsistent bedtimes, irregular sleep patterns could cause more than two-fold risk of developing cardiovascular disease

Brigham and Women’s Hospital

Boston, MA — The body’s clock keeps metabolism, blood pressure and heart rate running on schedule. But when an irregular sleep pattern disrupts this delicate ticking, what happens? A new study led by investigators from Brigham and Women’s Hospital measured participants’ sleep duration and timing, finding that over a five-year period, individuals who had the most irregular sleep experienced a two-fold increased risk of developing cardiovascular disease compared to those with the most regular sleep patterns. The team’s findings are published in The Journal of the American College of Cardiology.

“When we talk about interventions to prevent heart attacks and stroke, we focus on diet and exercise,” said lead author Tianyi Huang, ScD, of the Brigham’s Channing Division of Network Medicine. “Even when we talk about sleep, we tend to focus on duration — how many hours a person sleeps each night — but not on sleep irregularity and the impact of going to bed at different times or sleeping different amounts from night to night. Our study indicates that healthy sleep isn’t just about quantity but also about variability, and that this can have an important effect on heart health.”

Huang and colleagues examined data from the Multi-Ethnic Study of Atherosclerosis (MESA), a federally funded, prospective study that included 1,992 participants who did not have cardiovascular disease at the beginning of the study. MESA consisted of a diverse study population made up of white (38 percent), African American (28 percent), Hispanic (22 percent) and Chinese American (12 percent) participants, aged 45-84 years, from six field centers across the U.S. Participants wore an activity tracker on their wrist for seven days that recorded their sleep, including bedtime, sleep duration and wake time. They were then followed for an average of 4.9 years. During that time, 111 participants experienced cardiovascular events, including heart attack, stroke and other adverse events.

The investigators divided participants into four groups ranging from those with the most irregular sleep patterns (two hours or more difference in sleep duration each night) and those with the most regular sleep patterns (less than an hour difference in sleep duration each night). They also compared those with the most consistent bedtimes (less than 30-minute difference each night) and most inconsistent bedtimes (90 minutes or more). The team found a two-fold increase in risk of cardiovascular events among those with the most irregular sleep patterns. The researchers estimate that for every 1,000 people following the most regular sleep pattern, only eight would have a cardiovascular event over one year; for every 1,000 people with the most irregular sleep patterns, 20 people would likely develop a cardiovascular event over one year.

While large for a study that uses wrist-worn activity trackers to measure sleep, the sample size for the study was modest and its follow-up time was relatively short, which meant that the researchers could not assess risk of individual adverse events such as a heart attack versus a stroke and the possibility of chance findings could not be fully excluded. If larger studies confirm these findings in the future, Huang would like to evaluate whether an intervention — such as, sleeping longer or more regularly — could decrease a person’s risk.

“Sleep regularity is a modifiable behavior. In the future, we’d like to explore whether changing one’s sleep patterns by going to bed consistently each night may reduce a person’s risk of future cardiovascular events,” said Huang.

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This research was supported by the National Heart, Lung and Blood Institute (HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169, K01HL143034, R35HL135818) and the National Center for Advancing Translational Sciences (grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420). The MESA Sleep Study was supported by NHLBI grant HL56984. A co-author reports consulting fees from Jazz Pharmaceutical and Respircardia Inc., and grant support from Jazz Pharmaceutical unrelated to this work.

Paper cited: Huang, T et al. “Actigraphy-measured Sleep Regularity and Risk of Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis” Journal of the American College of Cardiology DOI: 10.1016/j.jacc.2019.12.054

Brigham Health, a global leader in creating a healthier world, consists of Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital, the Brigham and Women’s Physicians Organization and many related facilities and programs. With more than 1,000 inpatient beds, approximately 60,000 inpatient stays and 1.7 million outpatient encounters annually, Brigham Health’s 1,200 physicians provide expert care in virtually every medical and surgical specialty to patients locally, regionally and around the world. An international leader in basic, clinical and translational research, Brigham Health has nearly 5,000 scientists, including physician-investigators, renowned biomedical researchers and faculty supported by over $700 million in funding. The Brigham’s medical preeminence dates back to 1832, and now, with 19,000 employees, that rich history is the foundation for its commitment to research, innovation, and community. Boston-based Brigham and Women’s Hospital is a teaching affiliate of Harvard Medical School and dedicated to educating and training the next generation of health care professionals. For more information, resources, and to follow us on social media, please visit brighamandwomens.org.

5000/5000Character limit: 5000上床时间不一致，不规律的睡眠方式可能导致患心血管疾病的风险增加两倍以上

百翰妇女医院

马萨诸塞州波士顿市-身体的时钟可使新陈代谢，血压和心率按计划运行。但是，当不规则的睡眠方式破坏了这种细微的滴答声时，会发生什么呢？由布莱根妇女医院的研究人员领导的一项新研究对参与者的睡眠时间和时间进行了测量，发现在五年时间内，睡眠最不规律的人患心血管疾病的风险增加了两倍。最规律的睡眠方式。研究小组的发现发表在《美国心脏病学会杂志》上。

“当我们谈论预防心脏病发作和中风的干预措施时，我们将重点放在饮食和运动上，”百翰姆网络医学钱宁分部的首席作者黄天一说。 “即使我们谈论睡眠，我们也倾向于关注持续时间-一个人每晚睡几个小时-而不关注睡眠不规律以及在不同时间上床或晚上到晚上睡觉量不同的影响。我们的研究表明，健康的睡眠不仅与数量有关，而且与变异性有关，这可能对心脏健康产生重要影响。”

Huang和同事们研究了一项由联邦资助的前瞻性研究，即多民族动脉粥样硬化研究（MESA）的数据，该研究包括1,992名在研究开始时没有患心血管疾病的参与者。 MESA由来自美国六个地区中心的年龄在45-84岁的白人（38％），非洲裔美国人（28％），西班牙裔（22％）和华裔美国人（12％）组成，研究对象多样化。参与者在手腕上佩戴了一个活动跟踪器，记录了他们的睡眠时间，包括跟踪就寝时间，睡眠时间和唤醒时间，为期7天。随后平均随访了4.9年。在此期间，有111名参与者经历了心血管事件，包括心脏病发作，中风和其他不良事件。

研究人员将参与者分为四组，从睡眠模式最不规则的人（每晚的睡眠时间差异两个小时或更多）到睡眠模式最规则的人（每晚的睡眠时间差异小于一小时）。他们还比较了就寝时间最一致（每晚相差少于30分钟）和就寝时间最不一致（不超过90分钟）的时间。研究小组发现，睡眠模式最不规律的人发生心血管事件的风险增加了两倍。研究人员估计，按照最规律的睡眠方式，每千人中，只有八个人在一年内会发生心血管事件。对于每1000名睡眠方式最不规律的人，有20个人可能会在一年内发生心血管事件。

尽管这项研究规模很大，使用腕上活动追踪器来测量睡眠，但该研究的样本量适中，且随访时间相对较短，这意味着研究人员无法评估诸如心脏病发作与中风的关系以及偶然发现的可能性无法完全排除。如果将来有更大的研究证实这些发现，Huang希望评估干预措施（例如睡得更久或更规律）是否可以降低一个人的危险。

睡眠规律是一种可改变的行为。将来，我们想探讨一下通过每天晚上连续睡觉来改变自己的睡眠方式是否可以降低一个人将来发生心血管事件的风险，”黄仁勋说。

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这项研究得到了美国国家心肺血液研究所（HHSN268201500003I，N01-HC-95159，N01-HC-95160，N01-HC-95161，N01-HC-95162，N01-HC-95163，N01-HC- 95164，N01-HC-95165，N01-HC-95166，N01-HC-95167，N01-HC-95168，N01-HC-95169，K01HL143034，R35HL135818）和美国国家转化科学发展中心（UL1-TR- 000040，UL1-TR-001079和UL1-TR-001420）。 MESA睡眠研究得到了NHLBI资助HL56984的支持。合着者报告了Jazz Pharmaceutical和Respircardia Inc.的咨询费，并获得了Jazz Pharmaceutical与这项工作无关的支持。

论文引用：Huang，T等。 “根据体动图测量的睡眠规律和发生心血管疾病的风险：动脉粥样硬化的多民族研究”，美国心脏病学会杂志DOI：10.1016 / j.jacc.2019.12.054