Association of Sleep Duration with the Morbidity and Mortality of Coronary Artery Disease: A Meta-analysis of Prospective Studies

Purpose: Insufficient and excessive sleep duration have become increasingly common in modern society. Published literatures report controversial results about the association of sleep duration with coronary artery disease (CAD).

Methods: A comprehensive search was performed to identify related prospective studies providing quantitative estimates between sleep duration and CAD. Meta-analysis was applied to calculate the combined relative risks (RRs) with 95% confidence intervals (CI) for sleep with morbidity and mortality of CAD. The risk of bias was assessed by the Egger regression asymmetry test.

Results: Fifteen studies conformed to the criteria. Compared with normal sleep duration, the pooled RRs (95%CI) of short sleep duration were 1.10(1.04-1.17) and 1.25(1.06-1.47) for the morbidity and mortality of CAD, and the pooled RRs (95%CI) of long sleep duration were 1.03(0.92-1.16) and 1.26(1.11-1.42) for the morbidity and mortality of CAD, respectively. The effect of short and long sleep duration on mortality of CAD were always significantly greater than the morbidity of CAD.

Conclusions: Short sleep duration was associated with higher morbidity of CAD, and short sleepers and long sleepers had higher risk for CAD mortality. Keeping normal sleep duration is an appropriate recommendation to prevent and control CAD.