Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Department of Public Health, Dalla Lana School of Public Health, University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Ontario Tobacco Research Unit (OTRU), Toronto, Canada.
Sleep Health. 2020 Oct;6(5):702-714. doi: 10.1016/j.sleh.2020.03.008. Epub 2020 May 20.
To investigate the association between second-hand smoke (SHS) exposure and sleep disturbances by systematically reviewing the literature base and to quantify this association by conducting a meta-analysis.
We did a systematic search of five databases- PubMed, Embase, CINAHL Plus, Web of Science - Core Collection, and Google Scholar. The primary outcomes were short sleep duration (SSD), poor sleep quality (PSQ), and excessive daytime sleepiness (EDS).
Our systematic search yielded a total of 1623 studies. However, 12 studies qualified for qualitative synthesis and 11 studies (12 surveys) with adequate information were included in the meta-analysis involving 730,808 participants. All the studies were cross-sectional. We found an association between SHS exposure and SSD [pooled OR: 1.20 (95% CI, 1.09-1.33; p = 0.0003; I= 68%), N = 7]; EDS [pooled OR: 1.07 (95% CI, 1.01-1.13; p = 0.02; I = 0%), N = 4]; and PSQ [pooled OR: 1.12 (95% CI, 1.01-1.23; p = 0.03; I = 79%), N = 10]. Subgroup analyses suggest significant association between SHS exposure and PSQ among adolescents. However, no such association was observed among adults. In addition, no significant association was observed between PSQ and SHS exposure when biomarker was used to identify SHS exposure.
This study is the first systematic review and meta-analysis to examine the association between SHS exposure and sleep outcomes. Self-reported exposure to SHS is positively associated with SSD, EDS, and PSQ, although the effects are modest. Further studies with robust methodology to ascertain exposure information are warranted to further elucidate the relationship between SHS exposure and sleep disturbances.
通过系统综述调查二手烟（SHS）暴露与睡眠障碍之间的关联，并通过荟萃分析来量化这种关联。
我们对五个数据库- PubMed、Embase、CINAHL Plus、Web of Science - Core Collection 和 Google Scholar-进行了系统搜索。主要结果是睡眠时间短（SSD）、睡眠质量差（PSQ）和白天过度嗜睡（EDS）。
我们的系统搜索共产生了 1623 项研究。然而，有 12 项研究符合定性综合标准，有 11 项（12 项调查）具有足够信息的研究纳入了荟萃分析，涉及 730808 名参与者。所有研究均为横断面研究。我们发现 SHS 暴露与 SSD 之间存在关联[汇总 OR：1.20（95%CI，1.09-1.33；p=0.0003；I=68%），N=7]；EDS [汇总 OR：1.07（95%CI，1.01-1.13；p=0.02；I=0%），N=4]；PSQ [汇总 OR：1.12（95%CI，1.01-1.23；p=0.03；I=79%），N=10]。亚组分析表明，SHS 暴露与青少年 PSQ 之间存在显著关联。然而，在成年人中未观察到这种关联。此外，当使用生物标志物来识别 SHS 暴露时，PSQ 与 SHS 暴露之间未观察到显著关联。
这是第一项系统综述和荟萃分析，旨在研究 SHS 暴露与睡眠结果之间的关联。自我报告的 SHS 暴露与 SSD、EDS 和 PSQ 呈正相关，尽管影响较小。需要进一步进行具有稳健方法学的研究来确定暴露信息，以进一步阐明 SHS 暴露与睡眠障碍之间的关系。
