Abstract
Hypertension is a global public issue, and sleep duration was regarded as its risk factors, however, the results were inconsistent. This study aims to deeply investigate and assess the association between sleep duration and hypertension. The electronic databases Cochrane Library, Pubmed and Embase updated to April, 30, 2020 were retrieved. Cohort studies that compared the long or short sleep duration versus normal sleep duration for the incidence of hypertension were included. The associations between sleep duration and hypertension were analyzed by meta-analyses, using risk ratio and 95% confidence interval as effect indexes. TSA software was used to assess the reliability of the pooled results and estimate the required sample size. A total of 11 studies (involving 85,838 subjects) were eligible for this meta-analysis. The association between short sleep duration and hypertension had statistical significances (RR = 1.161, 95% CI: 1.058–1.274), while there was no significant difference in ≥8 h group (RR = 1.059, 95% CI: 0.951–1.180). For short sleep hours, the required information size was calculated to be 44,889, and the number of subjects included in the meta-analysis exceeded the required information size. For long sleep hours, the required information size was 92,368, and the number of included subjects was less than that. The short sleep duration was confirmed to be a risk factor of the incidence of hypertension, future research should be conducted for some in-depth exploration. However, the significant association between long sleep duration and hypertension was not found, more studies should be conducted to confirm the pooled results.
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References
WHO. A global brief on hypertension: silent killer, global public health crisis (WHO/DCO/WHD/2013.2). Geneva, Switzerland: WHO; 2013.
Barnett R. Hypertension. Lancet. 2017;389:2365.
Calhoun DAHS. Sleep and hypertension. Chest. 2010;138:434–43.
Li M, Yan S, Jiang S, Ma X, Gao T, Li B. Relationship between sleep duration and hypertension in northeast China: a cross-sectional study. BMJ Open. 2019;9:e023916.
Grandner M, Mullington JM, Hashmi SD, Redeker NS, Watson NF, Morgenthaler TI. Sleep Duration and Hypertension: analysis of >700,000 adults by age and sex. J Clin Sleep Med. 2018;14:1031–9.
Zhao H, Gui W, Huang H, Liu Y, Ding H, Fan W, et al. Association of long-term sleep habits and hypertension: a cross-sectional study in Chinese adults. J Hum Hypertens. 2020;34:378–87.
Song Q, Liu X, Wang X, Wu S. Age- and gender-specific associations between sleep duration and incident hypertension in a Chinese population: the Kailuan study. J Hum Hypertens. 2016;30:503–7.
Gangwisch JE. A review of evidence for the link between sleep duration and hypertension. Am J Hypertens. 2014;27:1235–42.
Li H, Ren Y, Wu Y, Zhao X. Correlation between sleep duration and hypertension: a dose-response meta-analysis. J Hum Hypertens. 2019;33:218–28.
Lau JIJ, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med. 1997;127:820–6.
Higgins JPTS, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60.
Begg CBMM. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–101.
Egger M DSG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.
Jackowska M, Steptoe A. Sleep and future cardiovascular risk: prospective analysis from the English Longitudinal Study of Ageing. Sleep Med. 2015;16:768–74.
Yadav D, Hyun DS, Ahn SV, Koh SB, Kim JY. A prospective study of the association between total sleep duration and incident hypertension. J Clin Hypertens. 2017;19:550–7.
Lopez-Garcia E, Faubel R, Guallar-Castillon P, Leon-Munoz L, Banegas JR, Rodriguez-Artalejo F. Self-reported sleep duration and hypertension in older Spanish adults. J Am Geriatr Soc. 2009;57:663–8.
Drager LF, Santos RB, Silva WA, Parise BK, Giatti S, Aielo AN, et al. OSA, short sleep duration, and their interactions with sleepiness and cardiometabolic risk factors in adults: The ELSA-Brasil Study. Chest. 2019;155:1190–8.
Han B, Chen WZ, Li YC, Chen J, Zeng ZQ. Sleep and hypertension. Sleep Breath. 2020;24:351–6.
Kristian Thorlund JE, Jørn Wetterslev, Jesper Brok, Georgina Imberger, Christian Gluud. User manual for trial sequential analysis. Copenhagen: Copenhagen Trial Unit, 2017.
Acknowledgements
We gratefully acknowledge all research assistants for their contribution to this study. This study was funded by Social Science foundation of Ministry of Education of China (grant number: 18XJC910001).
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Wang, L., Hu, Y., Wang, X. et al. The association between sleep duration and hypertension: a meta and study sequential analysis. J Hum Hypertens 35, 621–626 (2021). https://doi.org/10.1038/s41371-020-0372-y
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DOI: https://doi.org/10.1038/s41371-020-0372-y
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