Insomnia may be an early risk factor for irregular heart rhythm

被诊断为失眠症的年轻人比那些没有失眠症病史的人更容易出现一种心律不齐的情况，而且发生得更早, according to a large study of military veterans. 研究结果表明，难以入睡或保持睡眠可能是房颤的早期危险因素, or AFib.

越来越多的证据表明，睡眠障碍与心血管疾病的高风险有关, including AFib. The new study, published Wednesday in the Journal of the American Heart Association为这一证据增加了证据，并探讨了这些风险在生命早期可能开始的线上电子游戏飞禽走兽.

“我们对中老年人心房颤动的风险因素了解很多，但对生命早期的风险因素了解较少," said lead study author Dr. Allison Gaffey, 他是纽黑文耶鲁大学医学院心血管医学科的临床心理学家和讲师, Connecticut. “为了更好地指导早期预防工作，我们开始研究年轻人."

AFib occurs when there is a sustained irregular heart rhythm. It is typically diagnosed after age 60 and can lead to blood clots, stroke, heart failure and other types of heart problems. Prior research has linked sleep apnea, which causes breathing to stop and restart during sleep, to a higher risk for AFib. But the impact of other sleep problems on AFib is largely unknown.

研究人员回顾了100多万退伍军人的电子健康记录. 在研究开始时，参与者的平均年龄为28岁，并在2001年10月至2017年底期间接受了退伍军人健康管理局的医疗保健. The vast majority – 87% – were men and 61% had been in active duty. Roughly 11% had been diagnosed with insomnia.

Over 16 years of follow-up, 4,168 cases of AFib were diagnosed. 在研究开始时被诊断患有失眠症的退伍军人患AFib的风险比没有睡眠障碍的退伍军人高32%.

Being male or having a history of obesity, alcohol abuse, sleep apnea, high blood pressure, heart disease, 心力衰竭和精神疾病也会增加AFib的风险. But even after controlling for these factors, the higher AFib risk for people with insomnia persisted.

加菲和她的同事还分析了退伍军人出现心律不规律的年龄. 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, since it is already known to raise AFib risk. 他们发现，患有失眠症的退伍军人比没有睡眠问题的退伍军人平均早两年患上心房纤颤——42岁.8 years old, compared to 45.1.

Gaffey说，这些发现可能不适用于非退伍军人. "Veterans have unique health risks due to their service history, including a higher risk for traumatic brain injury, 精神疾病，如创伤后应激障碍, anxiety and depression and musculoskeletal conditions. They also may have more chronic pain. 这些因素中的任何一个都会影响他们睡个好觉的能力."

But, she said, 这些发现“表明有必要探索平民的失眠和心血管风险."

Cardiologist Dr. Jose Joglar, 他是达拉斯德州大学西南医学中心内科教授和临床心脏电生理学奖学金项目主任, 他说，需要对人们进行后续研究，以证实失眠确实是AFib的一个风险因素. Joglar was not involved in the new research.

However, he said, 有足够的证据表明睡眠不足会对心脏健康有害，因此应该鼓励失眠患者寻求医疗帮助.

"You don't need AFib to tell you that insomnia is bad," Joglar said.

Last year, 美国心脏协会将睡眠列入了对心脏和大脑健康至关重要的生活要素清单, recommending adults get an average seven to nine hours each night.

压力和焦虑往往是人们失眠的原因, Gaffey said, adding that sleep challenges can be overcome.

"First and foremost, 确定是否有方法可以减少或更好地管理生活中的压力," she said.

If that isn't enough, 加菲建议与卫生保健专业人员会面，讨论转介认知行为疗法, a sleep apnea evaluation or sleep medications. "Lifestyle-based approaches, including increasing physical activity, changing diet and lowering caffeine intake, may also help to improve sleep," she said.