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目的:探讨苏州市成年人睡眠状况与冠心病发病的关联。方法:使用中国慢性病前瞻性研究苏州市吴中区项目点53 269例30~79岁调查对象的基线和随访信息，剔除基线调查时自报患有冠心病、脑卒中、癌症的研究对象后，最终纳入分析51 929例研究对象。采用Cox比例风险回归模型分析各睡眠因素（打鼾症状、失眠症状、每日睡眠时长、午睡情况）、健康睡眠评分（0~3分）与冠心病发病风险的关联。结果:研究对象中位随访时间为11.12年，随访期间共诊断冠心病1 304例。调整潜在混杂因素后，与没有相应睡眠症状者相比，有时打鼾（ HR=1.20，95% CI：1.04~1.38）、经常打鼾（ HR=1.17，95% CI：1.02~1.33）、有失眠障碍（ HR=1.41，95% CI：1.12~1.78）、日间功能障碍（ HR=1.56，95% CI：1.20~2.03）、常年午睡（ HR=1.37，95% CI：1.19~1.59）均与冠心病发病风险增加相关。与健康睡眠评分为0~1分（睡眠最不健康）者相比，健康睡眠评分3分（睡眠最健康）者冠心病发病风险降低26%（ HR=0.74，95% CI：0.63~0.87）。分层分析结果显示，健康睡眠评分3分与冠心病发病风险的关联在低体力活动水平亚组中更明显（交互作用 P<0.05）。 结论:打鼾、失眠障碍、日间功能障碍、常年午睡均与冠心病发病风险增加相关，遵循健康的睡眠模式也许可以降低成年人冠心病发病风险。

Objective:To investigate the association between sleep status and the risk for coronary heart disease in adults in Suzhou.Methods:Using the baseline and follow up information of 53 269 local residents aged 30-79 years in China Kadoorie Biobank conducted in Wuzhong District, Suzhou, 51 929 subjects were included in this study after excluding those reporting coronary heart disease, stroke and cancer at the baseline survey. A Cox proportional hazards regression model was used to analyze the association of healthy sleep score (0-3 points) and sleep factors (snoring, insomnia, long sleep duration and nap) with the risk for coronary heart disease.Results:The median follow-up time was 11.12 years, and 1 304 individuals were diagnosed with coronary heart disease during the follow-up. After adjusting for potential confounders, occasional snoring ( HR=1.20, 95% CI: 1.04-1.38), usual snoring ( HR=1.17, 95% CI: 1.02-1.33), insomnia disorder ( HR=1.41, 95% CI: 1.12-1.78), daytime dysfunction ( HR=1.56, 95% CI: 1.20-2.03) and perennial nap ( HR=1.37, 95% CI: 1.19-1.59) were associated with increased risk of coronary heart disease. Compared with those with sleep score of 0 - 1 (low sleep quality), the people with sleep score of 3 had reduced risk of coronary heart disease by 26% ( HR=0.74, 95% CI: 0.63-0.87). Stratified analysis showed that the association of healthy sleep score 3 with risk of coronary heart disease was stronger in low physically active individuals (interaction P<0.05). Conclusions:Snoring, insomnia disorders, daytime dysfunction, and perennial napping were all associated with increased risk for coronary heart disease, and keep healthy sleep mode might reduce the risk for coronary heart disease in adults.