Lin Wang1, Qingqing Liu2, Mulalibieke Heizhati3, Xiaoguang Yao3, Qin Luo3, Nanfang Li4. 1. Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, China; Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China. 2. Department of Respiratory and Intensive care medicine of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China. 3. Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, China. 4. Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, China. Electronic address: lnanfang2016@sina.com.
Abstract
OBJECTIVE: Excessive daytime sleepiness (EDS) is a prevalent phenomenon in adults, and although cohort studies have reported an association between EDS and adverse health outcomes, the results are inconclusive. This meta-analysis summarizes the evidence from longitudinal cohort studies on the relationship between EDS and the risk of cardiovascular disease (CVD) or all-cause mortality. DESIGN: A meta-analysis of prospective cohort studies was conducted. SETTING AND PARTICIPANTS: We searched for relevant longitudinal cohort studies published through September 2019 using Web of Science, PubMed, Medline, and SciELO. MEASURES: The relative risk (RR) of EDS was pooled in random-effects or fixed-effects meta-analyses. Subgroup, sensitivity, and meta-regression analyses were performed to identify heterogeneous sources. Publication bias was assessed using the Begg and Egger tests. RESULTS: Seventeen studies (153,909 participants) were included. The mean follow-up was 5.4 (range, 2-13.8) years. The pooled relative risks of EDS were 1.28 [95% confidence interval (CI) 1.09-1.50] for total CVD events, 1.28 (95% CI 1.12-1.46) for coronary heart disease (CHD), 1.52 (95% CI 1.10-2.12) for stroke, 1.47 (95% CI 1.09-1.98) for CVD mortality, and 1.23 (95% CI 1.13-1.33) for all-cause mortality. Subgroup analyses by mean age, region, follow-up time, EDS assessment method, and year of publication yielded similar results. CONCLUSIONS AND IMPLICATIONS: EDS is a modest but statistically significant predictor for CVD events, coronary heart disease, stroke, and CVD and all-cause mortality. However, its prognostic value warrants further investigation to identify those at highest risk of mortality and in need of intervention to improve outcomes.
OBJECTIVE:Excessive daytime sleepiness (EDS) is a prevalent phenomenon in adults, and although cohort studies have reported an association between EDS and adverse health outcomes, the results are inconclusive. This meta-analysis summarizes the evidence from longitudinal cohort studies on the relationship between EDS and the risk of cardiovascular disease (CVD) or all-cause mortality. DESIGN: A meta-analysis of prospective cohort studies was conducted. SETTING AND PARTICIPANTS: We searched for relevant longitudinal cohort studies published through September 2019 using Web of Science, PubMed, Medline, and SciELO. MEASURES: The relative risk (RR) of EDS was pooled in random-effects or fixed-effects meta-analyses. Subgroup, sensitivity, and meta-regression analyses were performed to identify heterogeneous sources. Publication bias was assessed using the Begg and Egger tests. RESULTS: Seventeen studies (153,909 participants) were included. The mean follow-up was 5.4 (range, 2-13.8) years. The pooled relative risks of EDS were 1.28 [95% confidence interval (CI) 1.09-1.50] for total CVD events, 1.28 (95% CI 1.12-1.46) for coronary heart disease (CHD), 1.52 (95% CI 1.10-2.12) for stroke, 1.47 (95% CI 1.09-1.98) for CVDmortality, and 1.23 (95% CI 1.13-1.33) for all-cause mortality. Subgroup analyses by mean age, region, follow-up time, EDS assessment method, and year of publication yielded similar results. CONCLUSIONS AND IMPLICATIONS: EDS is a modest but statistically significant predictor for CVD events, coronary heart disease, stroke, and CVD and all-cause mortality. However, its prognostic value warrants further investigation to identify those at highest risk of mortality and in need of intervention to improve outcomes.
Authors: Jingen Li; Naima Covassin; Joshua M Bock; Essa A Mohamed; Lakshmi P Pappoppula; Chilsia Shafi; Francisco Lopez-Jimenez; Virend K Somers Journal: Nat Sci Sleep Date: 2021-07-06