{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:35:22Z","timestamp":1789619722295,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">There was little evidence about the role of objective sleep efficiency (SE) in the incidence of major cardiovascular disease (CVD) events. The purpose of this study was to investigate the correlation between objective SE and CVD based on polysomnography.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 3810 participants from the SHHS (Sleep Heart Health Study) were selected in the current study. CVD was assessed during an almost 11\u2010year follow\u2010up period. The primary composite cardiovascular outcome was major adverse cardiovascular events, defined as CVD mortality, congestive heart failure, myocardial infarction, and stroke. The secondary composite cardiovascular outcome was major adverse cardiovascular event plus revascularization. Objective measured SE, including SE and wake after sleep onset, was based on in\u2010home polysomnography records. Cox regression analysis was used to explore the association between SE and CVD. After multivariate Cox regression analysis, poor SE (&lt;80%) was significantly associated with primary (hazard ratio [HR], 1.338; 95% CI, 1.025\u20131.745;\n              <jats:italic>P<\/jats:italic>\n              =0.032) and secondary composite cardiovascular outcomes (HR, 1.250; 95% CI, 1.027\u20131.521;\n              <jats:italic>P<\/jats:italic>\n              =0.026); it was also found to be a predictor of CVD mortality (HR, 1.887; 95% CI, 1.224\u20132.909;\n              <jats:italic>P<\/jats:italic>\n              =0.004). Moreover, wake after sleep onset of fourth quartile (&gt;78.0\u00a0minutes) was closely correlated with primary (HR, 1.436; 95% CI, 1.066\u20131.934;\n              <jats:italic>P<\/jats:italic>\n              =0.017), secondary composite cardiovascular outcomes (HR, 1.374; 95% CI, 1.103\u20131.712;\n              <jats:italic>P<\/jats:italic>\n              =0.005), and CVD mortality (HR, 2.240; 95% CI, 1.377\u20133.642;\n              <jats:italic>P<\/jats:italic>\n              =0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Poor SE and long wake after sleep onset, objectively measured by polysomnography, were associated with the increased risk of incident CVD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016201","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T10:16:31Z","timestamp":1615803391000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":75,"title":["Objective Sleep Efficiency Predicts Cardiovascular Disease in a Community Population: The Sleep Heart Health Study"],"prefix":"10.1161","volume":"10","author":[{"given":"Bin","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Clinical Research Center The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"},{"name":"Department of Psychiatry The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Center The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"},{"name":"Department of Psychiatry The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Psychiatry The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7826-305X","authenticated-orcid":false,"given":"Xiancang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"},{"name":"Center of Brain Science The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000444"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsw058"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-562"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.1382"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/07420528.2016.1241802"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.08.014"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2017.04.013"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000711"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12515"},{"key":"e_1_3_2_13_2","first-page":"711","article-title":"Associations of Framingham risk score profile and coronary artery calcification with sleep characteristics in middle\u2010aged men and women: Pittsburgh SleepSCORE study","volume":"34","author":"Matthews KA","year":"2011","unstructured":"Matthews KA, Strollo PJ Jr, Hall M, Mezick EJ, Kamarck TW, Owens JF, Buysse DJ, Reis SE. 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