Sleep duration predicts cardiovascular outcomes: a systematic review and meta analysis of prospective studies.
Aims To assess the relationship between duration of sleep and morbidity and mortality from coronary heart disease (CHD) stroke, and total cardiovascular disease (CVD) Methods and results We performed a systematic search of publications using MEDLINE (1966 2009) EMBASE (from 1980) the Cochrane Library, and manual searches without language restrictions. Studies were included if they were prospective, follow up >3 years, had duration of sleep at baseline, and incident cases of CHD, stroke, or CVD. Relative risks (RR) and 95% confidence interval (CI) were pooled using a random effect model. Overall, 15 studies (24 cohort samples) included 474 684 male and female participants (follow up 6.9 25 years) and 16 067 events (4169 for CHD, 3478 for stroke, and 8420 for total CVD) Sleep duration was assessed by questionnaire and incident cases through certification and event registers. Short duration of sleep was associated with a greater risk of developing or dying of CHD (RR 1.48, 95% CI 1.22 1.80, P 0.0001) stroke (1.15, 1.00 1.31, P 0.047) but not total CVD (1.03, 0.93 1.15, P 0.52) with no evidence of publication bias (P 0.95, P 0.30, and P 0.46, respectively) Long duration of sleep was also associated with a greater risk of CHD (1.38, 1.15 1.66, P 0.0005) stroke (1.65, 1.45 1.87, P 0.0001) and total CVD (1.41, 1.19 1.68, P 0.0001) with no evidence of publication bias (P 0.92, P 0.96, and P 0.79, respectively) Conclusion Both short and long duration of sleep are predictors, or markers, of cardiovascular outcomes.
European heart journal