Wang Yan, Mei Hao, Jiang Yan-Rui, Sun Wan-Qi, Song Yuan-Jin, Liu Shi-Jian, Jiang Fan
Department of Developmental and Behavioral Pediatrics, Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center affiliated Shanghai Jiaotong University School of Medicine, Ministry of Education Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China.
Department of Epidemiology, Tulane University, New Orleans, LA.
J Clin Sleep Med. 2015 Sep 15;11(9):1047-56. doi: 10.5664/jcsm.5024.
Epidemiologic studies have shown that chronic short sleep may be associated with the development of hypertension; however, the results are controversial. This meta-analysis was conducted to determine whether the duration of sleep is associated with hypertension.
Reference databases (PubMed, EmBase, the Cochrane Library, Chinese Biological Medicine database) were searched for studies related to sleep duration and hypertension. Sleep duration categories (≤ 5 h, 6 h, 7 h, 8 h, ≥ 9 h) and prevalence or incidence of hypertension in each sleep category were extracted. A general analysis and subgroup analyses stratified by gender, age, study design, and different definitions of sleep duration were conducted to evaluate the relationship between sleep duration and hypertension.
Thirteen articles out of a total of 1,628 articles involving 347,759 participants met the inclusion criteria. A U-shaped change in pooled odds ratios (ORs) for hypertension due to the change of sleep duration was observed. The unadjusted OR for hypertension of individuals who slept ≤ 5 h vs. 7 h was 1.61, 95% CI = 1.28-2.02; those who slept ≥ 9 h vs. 7 h was 1.29, 95% CI = 0.97-1.71. The pooled ORs were still significant after adjusted by age and gender. Women deprived of sleep (sleep time ≤ 5 h vs. 7 h, OR = 1.68, 95% CI = 1.39-2.03) had a higher risk of hypertension than men (OR = 1.30, 95% CI = 0.93-1.83).
Excessively longer and shorter periods of sleep may both be risk factors for high blood pressure; these associations are stronger in women than men.
流行病学研究表明，长期睡眠不足可能与高血压的发生有关；然而，结果存在争议。本荟萃分析旨在确定睡眠时间是否与高血压有关。
检索参考数据库（PubMed、EmBase、Cochrane图书馆、中国生物医学数据库）中与睡眠时间和高血压相关的研究。提取睡眠时间类别（≤5小时、6小时、7小时、8小时、≥9小时）以及每个睡眠类别中高血压的患病率或发病率。进行了总体分析以及按性别、年龄、研究设计和睡眠时间不同定义分层的亚组分析，以评估睡眠时间与高血压之间的关系。
在总共1628篇涉及347759名参与者的文章中，有13篇符合纳入标准。观察到由于睡眠时间变化导致的高血压合并比值比（OR）呈U形变化。睡眠时间≤5小时与7小时的个体相比，高血压的未调整OR为1.61，95%置信区间 = 1.28 - 2.02；睡眠时间≥9小时与7小时的个体相比，OR为1.29，95%置信区间 = 0.97 - 1.71。经年龄和性别调整后，合并OR仍然显著。睡眠不足的女性（睡眠时间≤5小时与7小时相比，OR = 1.68，95%置信区间 = 1.39 - 2.03）患高血压的风险高于男性（OR = 1.30，95%置信区间 = 0.93 - 1.83）。
睡眠时间过长和过短都可能是高血压的危险因素；这些关联在女性中比男性更强。
