CC：睡眠模式和脓毒症发生的关联

Abstract

Background: The role that sleep patterns play in sepsis risk remains poorly understood.睡眠模式在脓毒症风险中的作用尚不清楚。

Objectives: The objective was to evaluate the association between various sleep behaviours and the incidence of sepsis.本研究旨在评估各种睡眠行为与脓毒症发病率之间的相关性。

Methods: In this prospective cohort study, we analysed data from the UK Biobank (UKB). A total of 409,570 participants who were free of sepsis at baseline were included. We used a composite sleep score that considered the following five sleep behaviours: sleep chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Cox proportional hazards regression analysis was used to estimate the associations between healthy sleep scores and incident sepsis.本研究为前瞻性队列研究，分析了英国生物样本库（UK Biobank，UKB）的数据，共纳入409,570名基线时无脓毒症的参与者。我们采用了一个综合睡眠评分，考虑了以下五种睡眠行为：睡眠类型、睡眠时长、失眠、打鼾和白天嗜睡。使用Cox比例风险回归分析来估计健康睡眠评分与脓毒症发病之间的关联。

Results: During a mean follow-up of 13.54 years, 13,357 (3.26%) incident sepsis cases were recorded. Among the 409,570 participants with a mean age of 56.47 years, 184,124 (44.96%) were male; 9942 (2.43%) reported 0 to 1 of the five healthy sleep behaviours; 46,270 (11.30%) reported 2 behaviours; 115,272 (28.14%) reported 3 behaviours; 150,522 (36.75%) reported 4 behaviours; and 87,564 (21.38%) reported 5 behaviours at baseline. Each one-point increase in the sleep score was associated with a 5% lower risk of developing sepsis (hazard ratio (HR), 0.95; 95% confidence interval (CI), 0.93-0.97). Compared with a healthy sleep score of 0-1, for a sleep score of 5, the multivariate-adjusted HR (95% CI) for sepsis was 0.76 (0.69-0.83). In addition, we found that the negative correlation was stronger in participants who were aged < 60 years than in their older counterparts (p for interaction < 0.001). However, healthy sleep pattern was not associated with sepsis-related death and critical care admission.在平均随访13.54年期间，共记录了13,357例（3.26%）脓毒症发病病例。在平均年龄为56.47岁的409,570名参与者中，184,124名（44.96%）为男性；9942名（2.43%）报告有0~1种健康睡眠行为；46,270名（11.30%）报告有2种行为；115,272名（28.14%）报告有3种行为；150,522名（36.75%）报告有4种行为；87,564名（21.38%）报告有5种行为。每增加1分睡眠评分，发生脓毒症的风险降低5%（风险比[HR]，0.95；95%置信区间[CI]，0.93~0.97）。与健康睡眠评分为0~1相比，评分为5时，多变量调整后的脓毒症HR（95% CI）为0.76（0.69~0.83）。此外，我们发现这种负相关在年龄<60岁的参与者中比在年龄较大的参与者中更强（交互作用P值<0.001）。然而，健康睡眠模式与脓毒症相关死亡和重症监护病房（ICU）入院无关。

Conclusions: Findings from this cohort study suggest that a healthy sleep pattern may reduce the risk of developing sepsis, particularly among younger individuals.本队列研究结果表明，健康睡眠模式可能降低发生脓毒症的风险，尤其是在年轻人中。