Relationship of Sleep Duration With All‐Cause Mortality and Cardiovascular Events: A Systematic Review and Dose‐Response Meta‐Analysis of Prospective Cohort Studies

Sep 11, 2017Journal of the American Heart Association

How Sleep Length Is Linked to Risk of Death and Heart Problems: A Review and Analysis of Long-Term Studies

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Abstract

The lowest risk of all-cause mortality and cardiovascular outcomes is associated with approximately 7 hours of sleep per day.

A U-shaped relationship exists between sleep duration and the risk of all-cause mortality, total cardiovascular disease, coronary heart disease, and stroke.
For sleep durations less than 7 hours, the risk of all-cause mortality increases by 6% for each hour of reduced sleep.
For sleep durations greater than 7 hours, the risk of all-cause mortality increases by 13% for each additional hour of sleep.
Similar patterns are observed for total cardiovascular disease, with a 6% increase in risk for each hour reduced and a 12% increase for each hour added.
For coronary heart disease, the risk increases by 7% with each hour of reduced sleep and by 5% with each additional hour of sleep.
Stroke risk also follows this pattern, with a 5% increase per hour of reduced sleep and an 18% increase per hour of additional sleep.

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BACKGROUND: Effects of extreme sleep duration on risk of mortality and cardiovascular outcomes remain controversial. We aimed to quantify the dose-response relationships of sleep duration with risk of all-cause mortality, total cardiovascular disease, coronary heart disease, and stroke.

METHODS AND RESULTS: PubMed and Embase were systematically searched for prospective cohort studies published before December 1, 2016, that examined the associations between sleep duration and at least 1 of the 4 outcomes in generally healthy populations. U-shaped associations were indicated between sleep duration and risk of all outcomes, with the lowest risk observed for ≈7-hour sleep duration per day, which was varied little by sex. For all-cause mortality, when sleep duration was <7 hours per day, the pooled relative risk (RR) was 1.06 (95% CI, 1.04-1.07) per 1-hour reduction; when sleep duration was >7 hours per day, the pooled RR was 1.13 (95% CI, 1.11-1.15) per 1-hour increment. For total cardiovascular disease, the pooled RR was 1.06 (95% CI, 1.03-1.08) per 1-hour reduction and 1.12 (95% CI, 1.08-1.16) per 1-hour increment of sleep duration. For coronary heart disease, the pooled RR was 1.07 (95% CI, 1.03-1.12) per 1-hour reduction and 1.05 (95% CI, 1.00-1.10) per 1-hour increment of sleep duration. For stroke, the pooled RR was 1.05 (95% CI, 1.01-1.09) per 1-hour reduction and 1.18 (95% CI, 1.14-1.21) per 1-hour increment of sleep duration.

CONCLUSIONS: Our findings indicate that both short and long sleep duration is associated with an increased risk of all-cause mortality and cardiovascular events.

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Relationship of Sleep Duration With All‐Cause Mortality and Cardiovascular Events: A Systematic Review and Dose‐Response Meta‐Analysis of Prospective Cohort Studies

Abstract

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