自我报告的睡眠时间与就业人群死亡率的关系：系统评价和荟萃分析。

Associations Between Self-Reported Sleep Duration and Mortality in Employed Individuals: Systematic Review and Meta-Analysis.

机构信息

Health Through Physical Activity Lifestyle and Sport Research Centre & Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, Department of Human Biology, 37716University of Cape Town, South Africa.

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam UMC, the Netherlands.

出版信息

Am J Health Promot. 2021 Jul;35(6):853-865. doi: 10.1177/0890117121992288. Epub 2021 Feb 11.

DOI:10.1177/0890117121992288

PMID:33567861

Abstract

OBJECTIVE

Sleeping less or more than the 7-8 h has been associated with mortality in the general population, which encompasses diversity in employment status, age and community settings. Since sleep patterns of employed individuals may differ to those of their unemployed counterparts, the nature of their sleep-mortality relationship may vary. We therefore investigated the association between self-reported sleep duration and all-cause mortality (ACM) or cardiovascular disease mortality (CVDM) in employed individuals.

DATA SOURCES

Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, searches between January 1990 and May 2020 were conducted in PubMed, Web of Science and Scopus. Inclusion/exclusion criteria: Included were prospective cohort studies of 18-64-year-old disease-free employed persons with sleep duration measured at baseline, and cause of death recorded prospectively as the outcome. Gray literature, case-control or intervention design studies were excluded.

DATA EXTRACTION

Characteristics of the studies, participants, and study outcomes were extracted. The quality and risk of bias were assessed using the Newcastle-Ottawa Scale.

DATA SYNTHESIS

The pooled relative risks (RR) with 95% confidence intervals (CI) were obtained with a random-effects model and results presented as forest plots. Heterogeneity and sensitivity analysis were assessed.

RESULTS

Shorter sleep duration (≤6 h) was associated with a higher risk for (ACM) (RR: 1.16, 95% CI: 1.11 -1.22) and CVDM (RR: 1.26, 95% CI: 1.12 -1.41) compared to 7-8 h of sleep, with no significant heterogeneity. The association between longer sleep (≥8 h) and ACM (RR: 1.18, 95% CI:1.12 -1.23, P < 0.001) needs to be interpreted cautiously owing to high heterogeneity (I = 86.0%, P < 0.001).

CONCLUSION

Interventions and education programs targeting sleep health in the workplace may be warranted, based on our findings that employed individuals who report shorter sleep appear to have a higher risk for ACM and CVDM.

摘要

目的

在一般人群中，睡眠少于或多于 7-8 小时与死亡率有关，其中包括就业状况、年龄和社区环境的多样性。由于在职人员的睡眠模式可能与失业人员不同，因此他们的睡眠与死亡率之间的关系可能有所不同。因此，我们调查了自我报告的睡眠时间与全因死亡率（ACM）或心血管疾病死亡率（CVDM）在在职人员中的关系。

数据来源

基于系统评价和荟萃分析的首选报告项目，在 PubMed、Web of Science 和 Scopus 中进行了 1990 年 1 月至 2020 年 5 月的搜索。纳入/排除标准：纳入了 18-64 岁无疾病的在职人员的前瞻性队列研究，在基线时测量了睡眠时间，并前瞻性记录了死亡原因作为结局。排除灰色文献、病例对照或干预设计研究。

数据提取

提取研究、参与者和研究结果的特征。使用纽卡斯尔-渥太华量表评估质量和偏倚风险。

数据分析

使用随机效应模型获得汇总相对风险（RR）和 95%置信区间（CI），并以森林图呈现结果。评估了异质性和敏感性分析。

结果

与 7-8 小时的睡眠相比，较短的睡眠时间（≤6 小时）与 ACM（RR：1.16，95%CI：1.11-1.22）和 CVDM（RR：1.26，95%CI：1.12-1.41）的风险更高，且无显著异质性。睡眠时间较长（≥8 小时）与 ACM（RR：1.18，95%CI：1.12-1.23，P<0.001）之间的关联需要谨慎解释，因为存在高度异质性（I=86.0%，P<0.001）。