Sleep Duration And Risk Of Coronary Heart Disease: A Meta-Analysis Of Prospective Cohort Studies

Objectives: We conducted a meta-analysis to evaluate the correlation between sleep duration and the risk of coronary artery disease(CHD)(morbidity and mortality),so as to provide scientific basis for the prevention and control of CHD.Methods: We searched Pub Med,EMBASE,the Cochrane Library,Web of Science,CBM,CNKI,WANGFANG and VIP for prospective cohort studies focusing on the relationship between sleep duration and CHD,the defination of long and short sleep time was longer and shorter than the reference time of each original study.The retrieval time is from the establishment of the database to June 282020,two evaluators independently selected and assessed articles,relevant data after adjusting confounding factors were extracted,Review Manager 5.3 and Stata 16.0.Results: There were 21 articles that met the inclusion criteria.14 prospective cohort studies were included with 899323 participants,and 7prospective cohort studies were included with 700814 participants.The results showed that compared with the reference group,the short sleep time group increased the morbidity of CHD by 14%(RR=1.14,95%CI: 1.10～1.19)and the mortality of CHD by 16%(RR=1.16,95%CI: 1.01～1.33);the long sleep time group increased the morbidity of CHD 8%(RR=1.08,95%CI: 1.01～1.16)and the mortality of CHD by 24%(RR=1.24,95%CI:1.09～1.41).Subgroup analysis showed that the main source of heterogeneity comes from gender.Funnel plot for Begg’s and egger’s test in this Meta-analysis showed no publication bias.In this study sensitivity analysis only excluded a single study in the study of the morbidity of coronary heart disease in short sleep group,but it did not affect the conclusion.Dose-response analysis indicated a non-linear relationship of sleep duration with CHD risk(P for non-linearity <0.001).The sleep duration is 6.5～8.0 hours with the lowest morbidity,and is 6.5～7.5 hours with the lowest mortality.Conclusions: There is a U-shaped relationship between sleep duration and CHD risk.Sleep time <6.5h/day is a risk factor for CHD,and sleep time>8.0h/day and 7.5h/day will increase the morbidity and mortality of CHD.Reasonable sleep time helps prevent CHD and its adverse outcomes.