40～65岁人群睡眠碎片化与动脉硬化的关联性研究OA

Background Fragmented sleep is recognized as a significant contributing factor to arteriosclerosis(AS)in middle-aged and elderly populations;however,the specific associations between fragmentation across distinct sleep stages and AS have not been fully elucidated.Objective To investigate the association between sleep fragmentation indices and AS in middle-aged and older adults.Methods From March to November 2022,individuals aged 40-65 years who underwent physical examinations at the Physical Examination Center of the First People's Hospital of Fuquan City were selected.Questionnaire surveys,brachial-ankle pulse wave velocity(baPWV)measurements,and sleep data collection using smart wristbands were conducted.Unconditional binary Logistic regression models and restricted cubic spline analyses were used to assess the associations of the sleep fragmentation index(SFI),NREM fragmentation index(NFI),and REM fragmentation index(RFI)with the risk of AS.Subgroup analyses were conducted by sex,habitual snoring,and overweight/obesity status.Results A total of 706 participants with complete baPWV measurements and continuous 3-day sleep monitoring data were included,of whom 347(49.15%)were classified as having AS.After adjusting for confounding variables,SFI,NFI,and RFI showed"U"-shaped or"J"-shaped non-linear associations with AS risk(PSFI-Non-linear=0.007,PNFI-Non-linear=0.031,PRFI-Non-linear=0.044),with the risk curves reaching the lowest levels around the inflection points(SFI ≈ 5.75,NFI ≈ 5.77,RFI ≈ 8.25).Multivariable unconditional binary Logistic regression analysis showed that,after adjustment for potential confounders,compared with the SFI T2 group(5.13-<6.39),the SFI T1 group(2.59-<5.13)was marginally associated with an increased risk of AS(OR=1.515,95%CI=1.001-2.295,P=0.05),whereas participants in the SFI T3 group(6.39-8.72)had a significantly higher risk of AS(OR=1.706,95%CI=1.053-2.766,P<0.05);compared with the RFI T1 group(0-<7.46),the RFI T3 group(9.22-19.35)was associated with an increased risk of AS(OR=1.706,95%CI=1.053-2.766,P<0.05).Subgroup analyses indicated that,at comparable levels of sleep fragmentation,men,habitual snorers,and overweight/obese individuals tended to exhibit higher risks of AS compared with women,non-habitual snorers,and normal-weight/underweight individuals(P<0.05).Conclusion Sleep fragmentation was nonlinearly associated with AS.Excessively high or low SFI levels and elevated RFI may be related to an increased risk of AS.Future large-scale prospective cohort studies are needed to further evaluate the utility of sleep fragmentation indices in AS risk assessment.