The baseline characteristics of study population.

Background
Sleep has a significant impact on the incidence of cardiovascular diseases (CVD), but there is no comprehensive research on this topic.
Aims
Assess the association between sleep factors and the risk of cardiovascular diseases in terms of comprehensive sleep behavior.
Methods
This study included 8,075 subjects from NHANES 2017–2020, excluding those with missing sleep/CVD data. Poor sleep factors: abnormal sleep duration (<7h or>8h), trouble sleeping, snoring, snort or stop breathing, sleepy during day. Each factor was scored (0–12 total), classifying sleep patterns as healthy (0–4), intermediate (5–8) or poor (9–12). Multivariable logistic regression analyzed the association between unhealthy sleep and CVD. Weighted data were used for restricted cubic spline (RCS) plots to assess the nonlinear relationship between sleep durations, bedtime, rising time and CVD.
Results
Adjusted models showed significant associations between poor sleep and heart failure, myocardial infarction, stroke and hypertension (p < 0.05). Daytime sleepiness also increased stroke and hypertension risks (p < 0.05). RCS plots revealed nonlinear relationships: 7–9 hours sleep/day minimized heart failure, myocardial infarction and hypertension risks; 6–8 hours/day minimized stroke risk. Bedtime showed J-shaped and U-shaped associations with myocardial infarction and hypertension.
Conclusion
This nationally representative survey revealed that poor sleep patterns, particularly sleep disorders, daytime sleepiness and reported breathing obstructions were significantly associated with an increased prevalence of cardiovascular diseases. Additionally, there was a nonlinear correlation between sleep duration, bedtime, rising time and the risk of developing cardiovascular diseases.

背景
睡眠对心血管疾病（cardiovascular diseases, CVD）的发病风险具有显著影响，但目前尚无针对该主题的综合性研究。

研究目的
本研究旨在从综合性睡眠行为维度，评估睡眠相关因素与心血管疾病发病风险之间的关联。

研究方法
本研究纳入2017-2020年美国国家健康与营养调查（National Health and Nutrition Examination Survey, NHANES）中的8075名受试者，剔除睡眠或心血管疾病数据缺失的个体。不良睡眠因素包括：睡眠时长异常（每日睡眠时长<7小时或>8小时）、入睡困难、打鼾、呼吸暂停或憋醒、日间嗜睡。对每项睡眠因素进行评分，总评分范围为0-12分，据此将睡眠模式划分为健康型（0-4分）、中间型（5-8分）与不良型（9-12分）。采用多变量logistic回归分析不良睡眠与CVD之间的关联；使用加权数据绘制限制性立方样条（restricted cubic spline, RCS）曲线，以评估睡眠时长、就寝时间、起床时间与CVD发病风险之间的非线性关联。

研究结果
校正后的混杂模型显示，不良睡眠与心力衰竭、心肌梗死、中风及高血压均存在显著关联（p<0.05）；日间嗜睡也会增加中风与高血压的发病风险（p<0.05）。限制性立方样条曲线分析揭示了非线性关联模式：每日睡眠7-9小时可使心力衰竭、心肌梗死及高血压的发病风险降至最低；每日睡眠6-8小时则可使中风风险降至最低。就寝时间与心肌梗死、高血压分别呈现J型和U型关联。

研究结论
此项全国代表性调查结果显示，不良睡眠模式——尤其是睡眠障碍、日间嗜睡以及自述存在呼吸阻塞症状——与心血管疾病患病率升高显著相关。此外，睡眠时长、就寝时间、起床时间与心血管疾病发病风险之间存在非线性关联。