Wang Shanshan, Li Zhexi, Wang Xiaoyu, Guo Sheng, Sun Yujing, Li Guohua, Zhao Chenhao, Yuan Wenhui, Li Meng, Li Xiaolei, Ai Sizhi
Department of Cardiology, Life Science Center, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, China.
Front Cardiovasc Med. 2022 Aug 11;9:930000. doi: 10.3389/fcvm.2022.930000. eCollection 2022.
The associations between sleep duration and cardiovascular diseases (CVDs) have been explored in many observational studies. However, the causality of sleep duration and many CVDs, such as coronary artery disease (CAD), heart failure (HF), and stroke, remains unclear. In this study, we conducted a systematic meta-review and meta-analysis of the results of observational and Mendelian randomization (MR) studies to examine how sleep duration impacts the risk of CVDs. We searched articles published in English and before 10 September 2021 in PubMed, Web of Science, and Embase. The articles were screened independently by two reviewers to minimize potential bias. We combined the meta-analyses of observational studies and 11 MR studies and summarized evidence of the effect of sleep duration on the risk of CAD, HF, stroke, and cardiovascular and all-cause mortality. Results showed that (a) evidence is accumulating that short sleep duration is a causal risk factor for CAD and HF; (b) abundant evidence from observational studies supports that long sleep duration is associated with the risk of CAD, stroke, and mortality, and long sleep duration has no causal associations with stroke and CAD in the MR studies; the causation of long sleep duration and other CVDs should be further studied; and (c) emerging evidence indicates that an increase in hours of sleep is associated with a decreased risk of CAD. Finally, we discussed the underlying pathophysiological mechanisms underlying short sleep duration and CVDs and suggested that increasing sleep duration benefits cardiovascular health.
许多观察性研究探讨了睡眠时间与心血管疾病（CVD）之间的关联。然而，睡眠时间与许多心血管疾病，如冠状动脉疾病（CAD）、心力衰竭（HF）和中风之间的因果关系仍不明确。在本研究中，我们对观察性研究和孟德尔随机化（MR）研究的结果进行了系统的荟萃综述和荟萃分析，以检验睡眠时间如何影响心血管疾病的风险。我们检索了在PubMed、科学网和Embase上发表的英文文章以及2021年9月10日前发表的文章。由两名审稿人独立筛选文章，以尽量减少潜在偏倚。我们合并了观察性研究和11项MR研究的荟萃分析，并总结了睡眠时间对CAD、HF、中风以及心血管疾病和全因死亡率风险影响的证据。结果表明：（a）越来越多的证据表明，短睡眠时间是CAD和HF的因果风险因素；（b）观察性研究的大量证据支持长睡眠时间与CAD、中风和死亡率风险相关，而在MR研究中，长睡眠时间与中风和CAD无因果关联；长睡眠时间与其他心血管疾病的因果关系应进一步研究；（c）新出现的证据表明，睡眠时间增加与CAD风险降低相关。最后，我们讨论了短睡眠时间与心血管疾病潜在的病理生理机制，并提出增加睡眠时间有益于心血管健康。
