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Sleep duration and health outcomes: an umbrella review

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Abstract

Purpose

To collect existing evidence on the relationship between sleep duration and health outcomes.

Methods

A thorough search was conducted in PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews from inception to January, 2021. Meta-analyses of observational and interventional studies were eligible if they examined the associations between sleep duration and human health.

Results

In total, this umbrella review identified 69 meta-analyses with 11 outcomes for cancers and 30 outcomes for non-cancer conditions. Inappropriate sleep durations may significantly elevate the risk for cardiovascular disease (CVD), cognitive decline, coronary heart disease (CHD), depression, falls, frailty, lung cancer, metabolic syndrome (MS), and stroke. Dose–response analysis revealed that a 1-h reduction per 24 hours is associated with an increased risk by 3–11% of all-cause mortality, CHD, osteoporosis, stroke, and T2DM among short sleepers. Conversely, a 1-h increment in long sleepers is associated with a 7–17% higher risk of stroke mortality, CHD, stroke, and T2DM in adults.

Conclusion

Inappropriate sleep duration is a risk factor for developing non-cancer conditions. Decreasing and increasing sleep hours towards extreme sleep durations are associated with poor health outcomes.

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Data availability

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability.

Not applicable.

Ethics approval and consent to participate.

Not applicable.

Consent for publication.

Not applicable.

Abbreviations

AD:

Alzheimer’s disease

ADHD:

Attention deficit hyperactivity disorder

CHD:

Coronary heart disease

CI:

Confidence interval

CKD:

Chronic kidney disease

CVD:

Cardiovascular disease

FLD:

Fatty liver disease

GDM:

Gestational diabetes mellitus

HDL:

High density lipoprotein

HR:

Hazard ratio

LDL:

Low density lipoprotein

LGA:

Large for gestational age

MCI:

Mild cognitive impairment

MS:

Metabolic syndrome

NA:

Not available

NFLD:

Nonalcoholic fatty liver disease

OR:

Odds ratio

RCTs:

Random control trials

RR:

Relative risk

SGA:

Small for gestational age

T2DM:

Type 2 diabetes mellitus

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Funding

This study was funded by the National Natural Science Foundation of China (Grant Numbers 81974098, 81770756) and Program from Department of Science and Technology of Sichuan Province (Grant Number 2020YJ0054), Post-Doctor Research Project, West China Hospital, Sichuan University (Grant Number 2019HXBH089), and Health Commission of Sichuan province (20PJ036).

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Authors and Affiliations

  1. Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China

    Jin Li, Dehong Cao, Yin Huang, Zeyu Chen, Ruyi Wang, Qiang Dong, Qiang Wei & Liangren Liu

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  1. Jin Li
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  2. Dehong Cao
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  3. Yin Huang
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  4. Zeyu Chen
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  6. Qiang Dong
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  7. Qiang Wei
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  8. Liangren Liu
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Contributions

JL and DHC searched, collected, analyzed the data, and wrote the manuscript. LRL and QW designed the study, supervised the project, and revised the manuscript. BC and YH assisted with detailed statistical analysis. ZYC, RYW, and QD helped with data extraction. All authors read and approved the final draft.

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Correspondence to Qiang Wei or Liangren Liu.

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Jin Li and Dehong Cao are Equal study contribution.

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Li, J., Cao, D., Huang, Y. et al. Sleep duration and health outcomes: an umbrella review. Sleep Breath 26, 1479–1501 (2022). https://doi.org/10.1007/s11325-021-02458-1

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