Sleep duration and risk of all-cause mortality: A flexible, non-linear, meta-regression of 40 prospective cohort studies

被引:202
作者
Liu, Tong-Zu [1 ,2 ]
Xu, Chang [1 ,3 ]
Rota, Matteo [4 ]
Cai, Hui [5 ,6 ]
Zhang, Chao [3 ]
Shi, Ming-Jun [7 ]
Yuan, Rui-Xia [8 ,9 ]
Weng, Hong [1 ]
Meng, Xiang-Yu [2 ]
Kwong, Joey S. W. [3 ,10 ]
Sun, Xin [10 ]
机构
[1] Wuhan Univ, Zhongnan Hosp, Dept Urol, Wuhan 430071, Peoples R China
[2] Wuhan Univ, Ctr Evidence Based Med, Wuhan, Peoples R China
[3] Hubei Univ Med, Taihe Hosp, Ctr Evidence based Med & Clin Res, Shiyan, Peoples R China
[4] IRCCS Ist Ric Farmacol Mario Negri, Dept Epidemiol, Via G La Masa 19, I-20156 Milan, Italy
[5] Vanderbilt Epidemiol Ctr, Dept Med, Nashville, TN USA
[6] Vanderbilt Ingram Canc Ctr, Nashville, TN USA
[7] French Natl Ctr Sci Res, Inst Curie, UMR 144, F-75248 Paris, France
[8] Wuhan Univ, Sch Publ Hlth, Dept Epidemiol & biostatist, Wuhan, Peoples R China
[9] Wuhan Univ, Global Hlth Inst, Wuhan, Peoples R China
[10] Sichuan Univ, West China Hosp, Chinese Evidence Based Med Ctr, Chinese Cochrane Ctr, Chengdu 610041, Peoples R China
关键词
Sleep duration; All-cause mortality; Dose-response relationship; Meta-analysis; C-REACTIVE PROTEIN; DOSE-RESPONSE DATA; 9-YEAR FOLLOW-UP; CARDIOVASCULAR-DISEASE; OLDER-ADULTS; GENDER-DIFFERENCES; PHYSICAL-ACTIVITY; NIGHTTIME SLEEP; BLADDER-CANCER; HEALTHY-ADULTS;
D O I
10.1016/j.smrv.2016.02.005
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Approximately 27-37% of the general population experience prolonged sleep duration and 12-16% report shortened sleep duration. However, prolonged or shortened sleep duration may be associated with serious health problems. A comprehensive, flexible, non-linear meta-regression with restricted cubic spline (RCS) was used to investigate the dose-response relationship between sleep duration and all-cause mortality in adults. Medline (Ovid), Embase, EBSCOhost-PsycINFO, and EBSCOhost-CINAHL Plus databases, reference lists of relevant review articles, and included studies were searched up to Nov. 29, 2015. Prospective cohort studies investigating the association between sleep duration and all-cause mortality in adults with at least three categories of sleep duration were eligible for inclusion. We eventually included in our study 40 cohort studies enrolling 2,200,425 participants with 271,507 deaths. A J-shaped association between sleep duration and all-cause mortality was present: compared with 7 h of sleep (reference for 24-h sleep duration), both shortened and prolonged sleep durations were associated with increased risk of all-cause mortality (4 h: relative risk [RR] = 1.05; 95% confidence interval [CI] = 1.02-1.07; 5 h: RR = 1.06; 95% CI = 1.03-1.09; 6 h: RR = 1.04; 95% CI = 1.03-1.06; 8 h: RR = 1.03; 95% CI = 1.02-1.05; 9 h: RR = 1,13; 95% CI = 1.10-1.16; 10 h: RR = 1.25; 95% CI = 1.22-1.28; 11 h: RR = 1.38; 95% CI = 1.33-1.44; n = 29; P < 0.01 for non-linear test). With regard to the night-sleep duration, prolonged night-sleep duration was associated with increased all-cause mortality (8 h: RR = 1.01; 95% CI = 0.99-1.02; 9 h: RR = 1.08; 95% CI = 1.05-1.11; 10 h: RR = 1.24; 95% CI = 1.21-1.28; n = 13; P < 0.01 for non-linear test). Subgroup analysis showed females with short sleep duration a day (<7 h) were at high risk of all-cause mortality (4 h: RR = 1.07; 95% CI = 1.02-1.13; 5 h: RR = 1.08; 95% CI = 1.03-1.14; 6 h: RR = 1.05; 95% CI = 1.02-1.09), but males were not (4 h: RR = 1.01; 95% CI = 0.96 1.06; 5 h: RR = 1.02; 95% CI = 0.97-1.08; 6 h: RR = 1.02; 95% CI = 0.98-1.06). The current evidence suggests that insufficient or prolonged sleep may increase all-cause mortality. Women may be more susceptible to short sleep duration on all-cause mortality. (C) 2016 Elsevier Ltd. All rights reserved.
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页码:28 / 36
页数:9
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