Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore.
Sleep Breath. 2024 Dec;28(6):2325-2334. doi: 10.1007/s11325-024-03092-3. Epub 2024 Aug 15.
The effect of various sleep traits on the risk of lung cancer differs among pre-existing studies. This study aims to systematically review and synthesise the association between sleep duration and insomnia with the incidence of lung cancer.
PubMed, Embase and The Cochrane Library were searched from inception to 23 April 2023 for observational studies examining the effect of sleep quantity or insomnia on lung cancer incidence. We pooled maximally-adjusted hazard ratios and odds ratios separately using random effects inverse variance weighted models. The risk of bias of observational studies was assessed using the Newcastle-Ottawa Scale.
We included 11 observational studies with a pooled cohort of 5,049,141 patients. The mean age of the patients was 49.5 ± 17.7 years, and 51.4% were males. The risk of bias ranged from low-moderate. Individuals who slept for a shorter or longer duration than the reference range of sleep per night showed an increased risk of lung cancer by 11% (HR:1.11; 95%CI:1.00-1.23) and 16% (HR:1.16; 95%CI:1.06-1.27) respectively. Furthermore, individuals with insomnia symptoms had a 9% greater risk of lung cancer than those without symptoms (HR:1.09; 95%CI:1.05-1.13).
This study suggests that insufficient sleep, excessive sleep and insomnia may be associated with an increased risk of lung cancer. Physicians should be mindful of this association and encourage healthy sleep practises among patients. Given the observed heterogeneity among some pre-existing studies, future research with longer periods of follow-up, greater control for covariates and objective testing of sleep parameters may add value to this topic.
不同的睡眠特征对肺癌风险的影响在先前的研究中有所不同。本研究旨在系统地回顾和综合分析睡眠时间和失眠与肺癌发病率之间的关系。
从建库至 2023 年 4 月 23 日，我们在 PubMed、Embase 和 The Cochrane Library 中检索了观察性研究，这些研究检查了睡眠量或失眠对肺癌发病率的影响。我们分别使用随机效应逆方差加权模型对最大限度调整后的风险比和比值比进行了汇总。使用纽卡斯尔-渥太华量表评估观察性研究的偏倚风险。
我们纳入了 11 项观察性研究，共有 5049141 名患者纳入汇总队列。患者的平均年龄为 49.5±17.7 岁，51.4%为男性。偏倚风险范围为低-中度。与每晚参考睡眠时间相比，睡眠时间较短或较长的个体患肺癌的风险分别增加了 11%（HR：1.11；95%CI：1.00-1.23）和 16%（HR：1.16；95%CI：1.06-1.27）。此外，有失眠症状的个体患肺癌的风险比无症状个体高 9%（HR：1.09；95%CI：1.05-1.13）。
本研究表明，睡眠不足、睡眠过多和失眠可能与肺癌风险增加有关。医生应该注意到这种关联，并鼓励患者养成健康的睡眠习惯。鉴于一些先前研究中存在观察到的异质性，未来具有更长随访时间、更好地控制协变量和客观测试睡眠参数的研究可能会为这个主题增添价值。
