BACKGROUND AND AIM Controversy exists regarding cardiovascular risk in relation to sleep duration. We determined sleep duration and major recurrent cardiovascular event associations in patients with obstructive sleep apnoea and established cardiovascular disease. METHODS Secondary analyses of the international, multicenter, Sleep Apnea Cardiovascular Endpoints trial. Sleep duration was estimated from overnight home oximetry (ApneaLink monitor) used for obstructive sleep apnoea diagnosis. Cox proportional hazards models were used to determine associations of categorized sleep duration (<6 h, 6-8 h (reference), and >8 h) and major cardiovascular outcomes: primary composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and any hospitalization for unstable angina, heart failure, or transient ischemic attack; secondary composite of cardiac and cerebral (stroke/transient ischemic attack) events. RESULTS Oximetry-derived sleep duration estimates were available in 2687 participants (mean 61.2 years, 80.9% males) who experienced a total of 436 cardiovascular events over a mean follow-up of 3.7 years. Compared to the reference category, sleep duration was not associated with risk of the primary composite cardiovascular outcome (adjusted hazard ratio (HR) 1.00, 95% confidence interval 0.76-1.33, and HR 1.22, 95% confidence interval 0.98-1.52, for sleep duration <6 and >8 h, respectively). However, long sleep was associated with increased cerebral events (HR 1.67, 95% confidence interval 1.17-2.39; P = 0.005) and stroke alone (HR 1.79, 95% confidence interval 1.22-2.63; P = 0.003). CONCLUSIONS Long sleep duration is associated with an increased risk of stroke but not cardiac events in obstructive sleep apnoea patients with existing cardiovascular disease. CLINICAL TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov (NCT00738179).

中文翻译：

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睡眠持续时间和心血管事件风险：SAVE 研究。

背景和目的 关于与睡眠时间相关的心血管风险存在争议。我们确定了阻塞性睡眠呼吸暂停和已确诊的心血管疾病患者的睡眠持续时间和主要复发性心血管事件的关联。方法 国际、多中心、睡眠呼吸暂停心血管终点试验的二级分析。睡眠持续时间是根据用于阻塞性睡眠呼吸暂停诊断的夜间家庭血氧饱和度测定法（ApneaLink 监测器）估算的。Cox 比例风险模型用于确定分类睡眠持续时间（<6 小时、6-8 小时（参考）和 >8 小时）与主要心血管结局的关联：心血管死亡、非致命性心肌梗死、非致命性心肌梗塞的主要复合致命中风，以及任何因不稳定心绞痛、心力衰竭或短暂性脑缺血发作而住院的患者；心脏和大脑（中风/短暂性脑缺血发作）事件的二次复合。结果 2687 名参与者（平均 61.2 岁，80.9% 男性）在平均 3.7 年的随访期间共经历了 436 次心血管事件，可获得血氧测定法得出的睡眠持续时间估计值。与参考类别相比，睡眠持续时间与主要复合心血管结局的风险无关（睡眠的调整风险比 (HR) 1.00，95% 置信区间 0.76-1.33，HR 1.22，95% 置信区间 0.98-1.52）持续时间分别 <6 和 >8 小时）。然而，长时间睡眠与脑事件增加有关（HR 1.67，95% 置信区间 1.17-2.39；P = 0.005）和单独的卒中（HR 1.79，95% 置信区间 1.22-2.63；P = 0.003）。结论 在患有心血管疾病的阻塞性睡眠呼吸暂停患者中，较长的睡眠时间与卒中风险增加相关，但与心脏事件风险无关。临床试验注册 该试验在 ClinicalTrials.gov (NCT00738179) 上注册。