失眠可能是心律失常的早期危险因素

Younger adults diagnosed with insomnia were more likely to develop a type of irregular heartbeat – and to do so earlier – than those without a history of insomnia, 根据一项针对退伍军人的大型研究. The findings suggest difficulty falling or staying asleep may be an early risk factor for atrial fibrillation, or AFib.

A growing body of evidence links sleep disturbances and disorders to a higher risk for cardiovascular problems, 包括AFib. 这项新研究周三发表在《沙巴足球体育平台》杂志上 美国心脏协会杂志, adds to that evidence and explores how early in life those risks may begin.

"We know a lot about the risk factors for AFib in middle-aged and older adults but less about risk factors earlier in life,该研究的主要作者Dr. Allison Gaffey, a clinical psychologist and instructor in the section of cardiovascular medicine at the Yale School of Medicine in New Haven, Connecticut. "To better guide efforts for earlier prevention, we started looking at younger adults."

心房颤动发生在持续不规则的心律时. 它通常在60岁后被诊断出来，并可能导致血栓, stroke, 心力衰竭和其他类型的心脏问题. 先前的研究与睡眠呼吸暂停有关, 是什么导致睡眠时呼吸停止又重新开始, 患心房纤颤的风险更高. 但其他睡眠问题对心房纤颤的影响在很大程度上是未知的.

Researchers looked back at electronic health records for more than 1 million veterans. Participants were an average 28 years old at the beginning of the study and received health care from the Veterans Health Administration between October 2001 and the end of 2017. 绝大多数(87%)是男性，61%是现役军人. 大约11%的人被诊断患有失眠症.

在16年的随访中，诊断出4168例AFib. Veterans who also had been diagnosed with insomnia at the beginning of the study had a 32% higher risk for AFib than those without the sleep disorder.

男性或有肥胖史, 酒精滥用, sleep apnea, 高血压, 心脏病, heart failure and a psychiatric disorder also increased the risk for AFib. 但即使控制了这些因素, 失眠症患者的AFib风险较高.

Gaffey and her colleagues also analyzed the age at which veterans developed the irregular heart rhythm. 他们在调整了患有睡眠呼吸暂停症的退伍军人的数据后得出了这一结论, 因为已经知道它会增加心房纤颤的风险. They found veterans with insomnia developed AFib more than two years earlier on average than those without sleep issues – at 42.8岁，而45岁.1.

The findings may not be generalizable to non-military veterans, Gaffey said. “由于退伍军人的服役经历，他们有独特的健康风险, 包括更高的创伤性脑损伤风险, 精神疾病，如创伤后应激障碍, 焦虑，抑郁和肌肉骨骼疾病. 他们也可能有更多的慢性疼痛. Just one of these factors can affect their ability to get a good night's sleep."

But, she said, the findings "suggest an imperative to explore insomnia and cardiovascular risk in civilians."

心脏病专家博士. Jose Joglar, a professor in the department of internal medicine and program director of the clinical cardiac electrophysiology fellowship program at UT Southwestern Medical Center in Dallas, said studies that follow people into the future are needed to confirm insomnia is indeed a risk factor for AFib. Joglar没有参与这项新研究.

However, he said, there is enough evidence showing poor sleep can be harmful to heart health that people who struggle with insomnia should be encouraged to seek medical assistance.

“你不需要AFib来告诉你失眠是不好的，”Joglar说.

Last year, the 美国心脏协会 added sleep to its Life's Essential 8 list of critical components for good heart and brain health, 建议成年人每晚平均睡7到9个小时.

Stress and anxiety are often to blame when people have trouble sleeping, Gaffey said, 他补充说，睡眠挑战是可以克服的.

“首先也是最重要的, determine if there are ways you can reduce or better manage the stress in your life," she said.

如果这还不够的话, Gaffey suggested meeting with a health care professional to discuss a referral for cognitive behavioral therapy, 睡眠呼吸暂停评估或睡眠药物. “Lifestyle-based方法, 包括增加体力活动, 改变饮食，减少咖啡因的摄入, 也可能有助于改善睡眠," she said.