睡眠时长与全因死亡率和心血管事件的关系：前瞻性队列研究的系统评价和剂量反应荟萃分析。
Relationship of Sleep Duration With All-Cause Mortality and Cardiovascular Events: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.
机构信息
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
出版信息
J Am Heart Assoc. 2017 Sep 9;6(9):e005947. doi: 10.1161/JAHA.117.005947.
BACKGROUND
Effects of extreme sleep duration on risk of mortality and cardiovascular outcomes remain controversial. We aimed to quantify the dose-response relationships of sleep duration with risk of all-cause mortality, total cardiovascular disease, coronary heart disease, and stroke.
METHODS AND RESULTS
PubMed and Embase were systematically searched for prospective cohort studies published before December 1, 2016, that examined the associations between sleep duration and at least 1 of the 4 outcomes in generally healthy populations. U-shaped associations were indicated between sleep duration and risk of all outcomes, with the lowest risk observed for ≈7-hour sleep duration per day, which was varied little by sex. For all-cause mortality, when sleep duration was <7 hours per day, the pooled relative risk (RR) was 1.06 (95% CI, 1.04-1.07) per 1-hour reduction; when sleep duration was >7 hours per day, the pooled RR was 1.13 (95% CI, 1.11-1.15) per 1-hour increment. For total cardiovascular disease, the pooled RR was 1.06 (95% CI, 1.03-1.08) per 1-hour reduction and 1.12 (95% CI, 1.08-1.16) per 1-hour increment of sleep duration. For coronary heart disease, the pooled RR was 1.07 (95% CI, 1.03-1.12) per 1-hour reduction and 1.05 (95% CI, 1.00-1.10) per 1-hour increment of sleep duration. For stroke, the pooled RR was 1.05 (95% CI, 1.01-1.09) per 1-hour reduction and 1.18 (95% CI, 1.14-1.21) per 1-hour increment of sleep duration.
CONCLUSIONS
Our findings indicate that both short and long sleep duration is associated with an increased risk of all-cause mortality and cardiovascular events.
背景
睡眠时间对死亡率和心血管疾病结局的影响仍存在争议。我们旨在量化睡眠时间与全因死亡率、总心血管疾病、冠心病和中风风险之间的剂量-反应关系。
方法
系统地检索了截至 2016 年 12 月 1 日发表的前瞻性队列研究，这些研究检查了睡眠时间与一般健康人群中至少 4 种结局之一之间的关系。睡眠时间与所有结局风险之间呈 U 型关联，每天约 7 小时的睡眠时间风险最低，且性别差异很小。对于全因死亡率，当睡眠时间<每天 7 小时时，每减少 1 小时的合并相对风险（RR）为 1.06（95%置信区间，1.04-1.07）；当睡眠时间>每天 7 小时时，每增加 1 小时的 RR 为 1.13（95%置信区间，1.11-1.15）。对于总心血管疾病，睡眠时间每减少 1 小时的合并 RR 为 1.06（95%置信区间，1.03-1.08），每增加 1 小时的 RR 为 1.12（95%置信区间，1.08-1.16）。对于冠心病，睡眠时间每减少 1 小时的合并 RR 为 1.07（95%置信区间，1.03-1.12），每增加 1 小时的 RR 为 1.05（95%置信区间，1.00-1.10）。对于中风，睡眠时间每减少 1 小时的合并 RR 为 1.05（95%置信区间，1.01-1.09），每增加 1 小时的 RR 为 1.18（95%置信区间，1.14-1.21）。
结论
我们的研究结果表明，无论是短时间睡眠还是长时间睡眠，都会增加全因死亡率和心血管事件的风险。
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