Abstract
Introduction: Although the proportion and duration of rapid eye movement (REM) sleep are correlated with neurological and cardiovascular diseases, whether REM sleep is associated with all-cause mortality in community-based populations remains unknown.Methods: A prospective study was performed within the Sleep Heart Health Study (SHHS, Registration NO. NCT00005275). Total sleep time, sleep efficiency, and REM sleep were measured using polysomnography. Cox proportional hazards regression models were used to estimate the association of the REM sleep with all-cause mortality.Results: Over a mean follow-up period of 11.0 ± 3.1 y, 1234 individuals (21.9%) died. In the entire population, reduced REM sleep was significantly associated with increasing all-cause mortality. After adjustment for age, sex, race, body mass index, smoking status, total cholesterol, triglycerides, high-density lipoprotein, history of diabetes and hypertension, and the apnea–hypopnea index, the duration and proportion of REM sleep were found to be significantly associated with all-cause mortality when the lowest and the highest REM quartile groups were compared (hazard ratio, 95% confidence interval: 1.727, 1.434-2.079; 1.545, 1.298-1.839; respectively).Conclusion: The proportion and duration of REM sleep are negatively associated with all-cause mortality. This finding emphasizes the importance of personalized sleep management in community-based populations.
Highlights
The proportion and duration of rapid eye movement (REM) sleep are correlated with neurological and cardiovascular diseases, whether REM sleep is associated with all‐cause mortality in community‐based populations remains unknown
In comparison to the alive group, the deceased group showed a significantly higher apnea-hypopnea index (AHI) (12.41 ± 15.33 vs. 9.53 ± 13.00 events/h), and prevalence of hypertension and diabetes mellitus; they showed a greater decrease in total-sleep time (340.21±67.28 vs. 361.40±59.86), sleep efficiency (78.79±11.31 vs. 82.45±9.90), and amount and proportion of deep sleep (P < 0.001 for all) (Table 1)
More adjustment with body mass index (BMI), AHI, smoking status, blood lipid spectrum, and histories of diabetes and hypertension in Model 2, led to a further decrease in the intensity of the association, which remained statistically significant (HR, 95% CI: 1.727, 1.434–2.079)
Summary
The proportion and duration of rapid eye movement (REM) sleep are correlated with neurological and cardiovascular diseases, whether REM sleep is associated with all‐cause mortality in community‐based populations remains unknown. Conclusion: The proportion and duration of REM sleep are negatively associated with all‐cause mortality This finding emphasizes the importance of personalized sleep management in community‐based populations. The sleep process can be divided into two predominant phases, non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. The present study, investigated the association between REM sleep and all-cause mortality using data from the Sleep Heart Health Study (SHHS), a large community-based perspective cohort
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