Wang Dongming, Li Wenzhen, Cui Xiuqing, Meng Yidi, Zhou Min, Xiao Lili, Ma Jixuan, Yi Guilin, Chen Weihong
Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Wuhan Hospital for the Prevention and Treatment of Occupational Diseases, Wuhan, Hubei 430030, China.
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Int J Cardiol. 2016 Sep 15;219:231-9. doi: 10.1016/j.ijcard.2016.06.027. Epub 2016 Jun 16.
Epidemiological studies suggest an association between sleep duration and risk of coronary heart disease, however, the results are controversial. We conducted this systematic review and meta-analysis to summarize the potential dose-response relationship between sleep duration and risk of coronary heart disease.
The electronic reference databases (PubMed and Embase) were searched through January 2016 with selection criteria for relevant studies. Both semiparametric and parametric methods were used to calculate the pooled risk estimates.
Seventeen articles with 22 independent reports involving 17,841 incident cases of coronary heart disease among 517,440 participants were included in our meta-analysis. A U-shaped relationship was detected between sleep duration and risk of coronary heart disease, with the lowest risk at 7-8h per day. Compared with 7h sleep duration per day, the combined relative risk of coronary heart disease were 1.11 (95% CI=1.05-1.16) for an reduction of 1h and 1.07 (95% CI=1.00-1.15) for an increment of 1h. And the results almost did not change in the subgroup analysis of gender and fatal cases. Exclusion of any single study did not alter the combined relative risk. In addition, visual inspection of funnel plots, Begg's and Egger's tests failed to identify publication bias.
Both short and long sleep durations are significantly associated with increased risk of coronary heart disease. Compared with 7h sleep duration per day, the risk of coronary heart disease increases 11% for an hour decrease and increases 7% for an hour increase.
流行病学研究表明睡眠时间与冠心病风险之间存在关联，然而，结果存在争议。我们进行了这项系统评价和荟萃分析，以总结睡眠时间与冠心病风险之间潜在的剂量反应关系。
检索电子参考文献数据库（PubMed和Embase）至2016年1月，纳入相关研究的选择标准。采用半参数和参数方法计算合并风险估计值。
我们的荟萃分析纳入了17篇文章，包含22份独立报告，涉及517,440名参与者中的17,841例冠心病发病病例。睡眠时间与冠心病风险之间呈U型关系，每天睡眠7 - 8小时风险最低。与每天睡眠7小时相比，睡眠时间减少1小时，冠心病合并相对风险为1.11（95%CI = 1.05 - 1.16）；睡眠时间增加1小时，冠心病合并相对风险为1.07（95%CI = 1.00 - 1.15）。在性别和致命病例的亚组分析中，结果几乎没有变化。排除任何一项研究均未改变合并相对风险。此外，通过漏斗图的直观检查、Begg检验和Egger检验均未发现发表偏倚。
睡眠时间过短和过长均与冠心病风险增加显著相关。与每天睡眠7小时相比，睡眠时间每减少1小时，冠心病风险增加11%；睡眠时间每增加1小时，冠心病风险增加7%。
