ASSOCIATION BETWEEN SHORT AND LONG SLEEP DURATION AND CARDIOVASCULAR OUTCOMES? A SYSTEMATIC REVIEW AND META-ANALYSIS

PurposeSleep duration is thought to play a key role in the development of metabolic syndrome. However, the results have been inconsistent.MethodsWe conducted a systematic review and meta-analysis of cohort studies and searched publications in PubMed, Embase, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov. The summary relative risks (RRs) were estimated using a random model. The sensitivity analysis was performed by sequentially excluding each study to test the robustness of the pooled estimates.FindingWe included 13 studies involving 300,202 patients in which short sleep and long sleep significantly increased the risk of metabolic syndrome 15% (RR = 1.15, 95%CI = 1.09-1.22, p < 0.001) and 19% (RR = 1.19, 95%CI = 1.05-1.35, p < 0.001). Moreover, the relationship between sleep duration and metabolic syndrome risk presented a U-shaped curve. Short and long sleep increased the risk of obesity by 14% (RR = 1.14, 95%CI = 1.07-1.22, p<0.001) and 15% (RR = 1.15, 95%CI = 1.00-1.30, p = 0.04), and high blood pressure 16% (RR = 1.16, 95%CI = 1.02-1.31, p = 0.03) and 13% (RR = 1.13, 95%CI = 1.04-1.24, p = 0.01), respectively. Short sleep can potentially increase the risk of high blood sugar by 12% (RR = 1.12, 95%CI = 1.00-1.15, P = 0.05).ImplicationsBased on our findings, sleep is a behavior that can be changed and is economical. Clinically doctors and health professionals should be encouraged to increase their efforts to promote healthy sleep for all people.

Download Full-text

Sleep duration and risk of all-cause mortality: a systematic review and meta-analysis

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796018000379 ◽

2018 ◽

Vol 28 (5) ◽

pp. 578-588 ◽

Cited By ~ 4

Author(s):

H. A. García-Perdomo ◽

J. Zapata-Copete ◽

C. A. Rojas-Cerón

Keyword(s):

Systematic Review ◽

Sleep Duration ◽

Neurological Disease ◽

Primary Outcome ◽

Search Strategy ◽

Meta Analysis ◽

Risk Difference ◽

Risk Of Bias ◽

Long Sleep ◽

All Cause Mortality

AbstractAimsTo determine the association between the sleep duration and the risk of all-cause mortality in adults.MethodsA search strategy was conducted in the MEDLINE, CENTRAL, EMBASE and LILACS databases. Searches were also conducted in other databases and unpublished literature. Cohort studies were included without language, time or setting restrictions. The risk of bias was evaluated with a modified Cochrane Collaboration's tool. An analysis of random effects was conducted. The primary outcome was all-cause mortality. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned comparisons were 7–9 h of sleep v. <7 h and the same reference v. >9 h.ResultsThirty-nine studies were included in our qualitative analysis, regarding the quantitative analysis, 19 studies were included in <7 v. 7–9 h analysis, and 18 studies in the >9 v. 7–9 h. A low risk of bias was shown for most of the study items. The overall RD for all-cause mortality was 0.09 (95% CI 0.07–0.11) favouring the >9 h group compared with our reference. In contrast, no differences were found between the <7 h and the reference sleep duration groups (RD 0.00, 95% CI 0.00–0.01).ConclusionWe found a probable association of long sleep duration and higher mortality; however, it could reflect an underlying systemic or neurological disease that cause sleep fragmentation, deterioration in quality and micro-awakenings.

Download Full-text

Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression

Sleep Medicine ◽

10.1016/j.sleep.2017.11.1014 ◽

2017 ◽

Vol 40 ◽

pp. e344 ◽

Cited By ~ 2

Author(s):

N. Watanabe ◽

J. Maki ◽

O. Itani ◽

D. Buysse ◽

Y. Kaneita

Keyword(s):

Systematic Review ◽

Health Outcomes ◽

Sleep Duration ◽

Meta Analysis ◽

Long Sleep ◽

Meta Regression

Download Full-text

Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies

European Heart Journal ◽

10.1093/eurheartj/ehr007 ◽

2011 ◽

Vol 32 (12) ◽

pp. 1484-1492 ◽

Cited By ~ 940

Author(s):

Francesco P. Cappuccio ◽

Daniel Cooper ◽

Lanfranco D'Elia ◽

Pasquale Strazzullo ◽

Michelle A. Miller

Keyword(s):

Systematic Review ◽

Sleep Duration ◽

Prospective Studies ◽

Meta Analysis ◽

Cardiovascular Outcomes

Download Full-text

Association between short and long sleep durations and cardiovascular outcomes: a systematic review and meta-analysis

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872617741733 ◽

2017 ◽

Vol 8 (8) ◽

pp. 762-770 ◽

Cited By ~ 17

Author(s):

Chayakrit Krittanawong ◽

Anusith Tunhasiriwet ◽

Zhen Wang ◽

HongJu Zhang ◽

Ann M Farrell ◽

...

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Sleep Duration ◽

Risk Ratio ◽

Meta Analysis ◽

Cardiovascular Disease Mortality ◽

Ovid Medline ◽

Hazard Ratios ◽

Disease Mortality ◽

Long Sleep

Background: A shorter sleep duration has been identified as a risk factor for cardiovascular diseases and increased mortality. It has been hypothesized that a short sleep duration may be linked to changes in ghrelin and leptin production, leading to an alteration of stress hormone production. Here, we conducted a systematic review and meta-analysis to investigate the potential relationship between a sleep duration and cardiovascular disease mortality. Methods: We conducted a comprehensive search of Ovid Medline In-Process and other non-indexed citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, and Scopus from database inception to March 2017. Observational studies were included if the studies reported hazard ratios or odds ratios of the associations between sleep durations (short and long) and cardiovascular disease mortality. Data were extracted by a reviewer and then reviewed by two separate reviewers. Conflicts were resolved through consensus. Using the DerSimonian and Laird random effects models, we calculated pooled hazard ratios and pooled odds ratios with 95% confidence intervals (CI). Subgroup analyses were performed to explore potential sources of heterogeneity. The quality of the included studies and publication bias were assessed. Results: In total, our meta-analysis included 19 studies (31 cohorts) with a total of 816,995 individuals with 42,870 cardiovascular disease mortality cases. In pooled analyses, both short (risk ratio 1.19; 95% CI 1.13 to 1.26, P<0.001, I2=30.7, Pheterogeneity=0.034), and long (risk ratio 1.37; 95% CI 1.23 to 1.52, P<0.001, I2=79.75, Pheterogeneity<0.001) sleep durations were associated with a greater risk of cardiovascular disease mortality. Conclusions: Both short (<7 hours) and long sleep durations (>9 hours) can increase the risk of overall cardiovascular disease mortality, particularly in Asian populations and elderly individuals. Future epidemiological studies would ideally include objective sleep measurements, rather than self-report measures, and all potential confounders, such as genetic variants.

Download Full-text