睡眠时长与精神障碍风险的关联：系统回顾和荟萃分析。
Association of sleep duration and risk of mental disorder: a systematic review and meta-analysis.
机构信息
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
出版信息
Sleep Breath. 2024 Mar;28(1):261-280. doi: 10.1007/s11325-023-02905-1. Epub 2023 Aug 29.
BACKGROUND
The effects of sleep duration on the development of mental illness remain controversial. Therefore, it is necessary to identify the effects of long or short sleep duration on psychological disorders, which could reveal new ways for preventing and treating mental health conditions cheaply.
METHODS
Identifying published papers was accomplished by using the following five English databases on March 16, 2022: PubMed, MEDLINE, Embase, Web of Science databases, and Scopus. Cross-sectional and cohort studies were considered if they evaluated the association of sleep duration with all kinds of mental illness in adults. We excluded case reports, editorials, narrative reviews, and studies without detailed information on sleep duration. Summary effect-size estimates were expressed as risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals and were evaluated using random-effect models. Mantel-Haenszel's random-effects model was used to estimate the inconsistency index (I) and Tau index (measurement of heterogeneity).
RESULTS
A total of 52 studies were included in this analysis, consisting of 14 cohort studies and 38 cross-sectional studies. These studies involved a combined sample size of 1,407,891 participants who met the inclusion criteria. Cohort (adjusted RR = 1.42, 95% CI: 1.26-1.60, P < .001, I = 37.6%, Tau = 0.014) and cross-sectional studies (adjusted OR = 1.67, 95% CI: 1.57-1.77, P < .001, I = 79.7%, Tau = 0.060) concluded that short sleep duration increased mental disorder risks. The same conclusions were acquired in the subgroup analysis, especially for depression (adjusted RR = 1.43, 95% CI: 1.24-1.65, P < .001, I = 80.4%, Tau = 0.082), anxiety (adjusted RR = 1.30, 95% CI: 1.04-1.63, P = .002, I = 0.0%, Tau = 0.000), and PTSD (adjusted RR = 1.35, 95% CI: 1.04-1.76, P = .022, I = 24.1%, Tau = 0.013) in cohort studies. The results of subgroup analysis indicated that long sleep duration was not a risk factor for depression (adjusted RR = 1.15, 95% CI: 0.98-1.34, P = .088, I = 63.4%, Tau = 0.045) and anxiety (adjusted RR = 1.37, 95% CI: 0.93-2.03, P = .114, I = 0.0%, Tau = 0.000).
CONCLUSIONS
Short sleep duration, not long sleep duration, is an independent predictor of developing mental disorders, particularly anxiety and depression.
背景
睡眠时长对精神疾病发展的影响仍存在争议。因此，有必要确定长或短的睡眠时长对心理障碍的影响，这可能为廉价预防和治疗心理健康状况提供新的途径。
方法
于 2022 年 3 月 16 日使用以下五个英文数据库确定已发表的论文：PubMed、MEDLINE、Embase、Web of Science 数据库和 Scopus。如果研究评估了睡眠时长与成年人所有类型的精神疾病之间的关联，则将其视为横断面和队列研究。我们排除了病例报告、社论、叙述性评论以及没有详细睡眠时长信息的研究。汇总的效应大小估计值表示为风险比 (RR) 或比值比 (OR)，置信区间为 95%，并使用随机效应模型进行评估。Mantel-Haenszel 的随机效应模型用于估计不一致指数 (I) 和 Tau 指数（衡量异质性）。
结果
共有 52 项研究纳入了本分析，包括 14 项队列研究和 38 项横断面研究。这些研究共纳入了 1407891 名符合纳入标准的参与者。队列研究（调整后的 RR = 1.42，95%CI：1.26-1.60，P <.001，I = 37.6%，Tau = 0.014）和横断面研究（调整后的 OR = 1.67，95%CI：1.57-1.77，P <.001，I = 79.7%，Tau = 0.060）表明，短睡眠时长会增加精神障碍风险。在亚组分析中也得出了相同的结论，尤其是在抑郁症（调整后的 RR = 1.43，95%CI：1.24-1.65，P <.001，I = 80.4%，Tau = 0.082）、焦虑症（调整后的 RR = 1.30，95%CI：1.04-1.63，P =.002，I = 0.0%，Tau = 0.000）和 PTSD（调整后的 RR = 1.35，95%CI：1.04-1.76，P =.022，I = 24.1%，Tau = 0.013）中。亚组分析的结果表明，长睡眠时长不是抑郁症（调整后的 RR = 1.15，95%CI：0.98-1.34，P =.088，I = 63.4%，Tau = 0.045）和焦虑症（调整后的 RR = 1.37，95%CI：0.93-2.03，P =.114，I = 0.0%，Tau = 0.000）的危险因素。
结论
短睡眠时长而非长睡眠时长是精神障碍发展的独立预测因素，尤其是焦虑和抑郁。
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