研究发现睡眠缺乏同心脑血管疾病发病相关
No one likes to walk into work after just a few fitful hours of sleep. But now there's evidence that not getting enough sleep may have more serious consequences than dark circles under your eyes the next morning. Researchers at the University of Chicago report in the Journal of the American Medical Association that too little sleep can promote calcium buildup in the heart arteries, leading to the plaques that can then break apart and cause heart attacks and strokes.The University of Chicago team documented for the first time exactly how much of a risk shortened shut-eye can be — one hour less on average each night can increase coronary calcium by 16%. Among a group of 495 men and women aged 35 to 47, 27% of those getting less than five hours of sleep each night showed plaque in their heart vessels, while 11% of those sleeping the recommended five to seven hours did, and only 6% of subjects sleeping more than seven hours each night showed such atherosclerosis. \"We were surprised by the findings,\" says Diane Lauderdale, a professor of health studies at the University of Chicago and lead author of the study. \"We really were not expecting to find an association at all, and certainly not one that was this strong.\" (See the Top 10 Medical Breakthroughs of 2008.)
没人喜欢断断续续几小时的睡眠后步行去工作。但是现在有证据表明缺少睡眠比晨起后的黑眼圈可能有更严重的后果。Chicago大学的学者们在Journal of the American Medical Association报道称不足的睡眠可以造成钙在冠状动脉中集聚，导致斑块形成，当斑块破裂时会导致心脏病发作和中风。Chicago大学的研究小组首次精确报道了到底缺少多少睡眠时间会导致上述不良事件的发生---平均每夜缺少1小时的睡眠可以增加16%的冠状动脉钙化机率。在一项包含495名年龄在45-47之间的男女人群的研究，其中每晚睡眠小于5小时的人中，有27%的心脏血管中可见斑块，而睡眠时间在5-7小时之间的人仅有11%的心脏血管可见斑块，每晚超过7小时的人中仅有6%可见血管内有斑块形成。Chicago大学健康研究的教授并作为该研究发起人的Diane Lauderdale说“我们对此结果很惊讶，我们本来不指望发现其中有什么联系，至少不是显示出如此大差别的结果。”（见08年10大医学突破）
Lauderdale and her team had reason to be skeptical. While the connection between sleep and heart disease is of growing interest to researchers, earlier studies had been inconclusive, and plagued by biases, including the fact that most of the trials relied on people's self-reported accounts of their sleeping habits. The scientists knew that teasing apart the myriad processes that contribute to sleep, and then drawing scientifically sound connections between them and the host of things that can trigger heart disease, would be difficult at best. So the Chicago team isolated the most common confounding variables that could explain both poor sleep and heart problems, such as smoking, alcohol, and other medical conditions, and also found a way to record, as accurately as possible, the amount of sleep that the subjects got each night. Each volunteer wore a wrist monitor that measured and recorded activity at 30 second intervals; when the monitor was quiet, the subject was asleep.
Lauderdale和她的小组有理由怀疑。然而睡眠与心脏病之间的联系引起了学者们的兴趣，早期研究没有确切的结果，并且有较大的偏倚，包括大多数试验依赖人们的自我感觉这就很受其睡眠习惯的影响。科学家知道测试与睡眠的许多过程都是分离的，但是最后却得出一个看似科学的结果，说它们之间有联系，很多东西都可以引起心脏病，很难发现那种因素更容易引起心脏病。所以Chicago没有考虑许多混杂变量，这些变量也可以引起睡眠质量差和心脏问题，如吸烟，饮酒和其他相关因素，记录受试者每夜的睡眠量的方法越精确越好。每位志愿者携带可以每30秒测量和记录活动度的腕式检测器；当检测器平静时，说明受试者已经入睡。
While Lauderdale acknowledges that her results are far from the last word on sleep and heart disease, the study does suggest that doctors and patients should consider sleep in addition to the more familiar hazards for the heart such as high cholesterol, hypertension and diabetes. In Lauderdale's analysis, one additional hour of sleep was equivalent to lowering systolic blood pressure by 16.5mm Hg. \"We have enough evidence from this study and others to show that it is important to include sleep in any discussion of heart disease,\" says Dr. Tracy Stevens, spokesperson for the American Heart Association and a cardiologist at Saint Luke's Mid-America Heart Institute. \"We talk about the traditional risk factors, and now the other important thing we need to include is sleep.\"
当Lauderdale承认她的结果里睡眠与心脏病关系的最终结论还差很远，研究明确表明医生和患者也应该将睡眠视作为导致心脏病的风险因素，如高胆固醇，高血压和糖尿病。在Lauderdale的分析中，多睡1小时等同于减轻16.5mmHg的收缩水平。在美国心脏病协会代言人和Saint Luke's Mid-America Heart Institute 的心脏病学家Tracy Stevens说“我们有足够的来自此项研究和其他研究的证据表明在讨论心脏病时考虑睡眠因素尤为重要”。“我们以前谈论的是传统的危险因素，现在其他的重要因素如睡眠也应该被考虑。”
Exactly how a lack of sleep is feeding plaque in the heart arteries isn't yet clear, but one explanation may involve inflammation. Too little sleep can raise cortisol levels, which fuels inflammation that can destabilize plaques. Once these deposits rupture, they can block vessels in the heart or brain, causing a heart attack or stroke. While the Chicago team did not track levels of cortisol to test this theory, future studies might.
特别是目前仍不清楚为什么缺乏睡眠会导致心脏动脉斑块进展，但是一种解释是炎症相关性。缺少睡眠使皮质醇水平提高，它引起的炎症反应可以使斑块不稳定。一旦这些沉积物破裂，它们可以堵塞心脏或者脑部血管，导致心脏病和中风。而Chicago的研究小组并没有通过跟踪记录皮质醇的水平验证该结论，以后的研究中可能会考虑该点。
A simpl er explanation might involve blood pressure. In general, blood pressure dips during sleep, and over a 24 hour period, people sleeping less will have shorter periods of lower blood pressure, thus increasing their tendency to dislodge any unstable plaques.
一种简单的解释可能与血压有关。通常情况，在睡眠时血压下降，在24小时内，缺少睡眠的人血压处于低水平的时间就不够，这样就增加了他们不稳定斑块破裂的风险。
Whatever the reason might be, the results of this study make it clear that sleep isn't just for dreamers. Getting enough sleep might just save your heart
无论原因是什么，该研究的结果很明确的表明睡眠不仅是为了做梦。充足的睡眠可以保护你的心脏。
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