Associations between self-reported sleep duration, all-cause and cardiovascular disease mortality in employed individuals: a systematic review and meta-analysis

Pienaar, Paula R. and Kolbe-Alexander, Tracy L. ORCID: and van Mechelen, Willem and Boot, Cecile R. L. and Roden, Laura C. and Lambert, Estelle V. and Rae, Dale E. (2021) Associations between self-reported sleep duration, all-cause and cardiovascular disease mortality in employed individuals: a systematic review and meta-analysis. American Journal of Health Promotion, 35 (6). pp. 853-865. ISSN 0890-1171


Objective: Sleeping less or more than the 7-8 h has been associated with mortality in the general population, which encompasses diversity in employment status, age and community settings. Since sleep patterns of employed individuals may differ to those of their unemployed counterparts, the nature of their sleep-mortality relationship may vary. We therefore investigated the association between self-reported sleep duration and all-cause mortality (ACM) or cardiovascular disease mortality (CVDM) in employed individuals.

Data sources: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, searches between January 1990 and May 2020 were conducted in PubMed, Web of Science and Scopus. Inclusion/exclusion criteria: Included were prospective cohort studies of 18–64-year-old disease-free employed persons with sleep duration measured at baseline, and cause of death recorded prospectively as the outcome. Gray literature, case-control or intervention design studies were excluded.

Data Extraction: Characteristics of the studies, participants, and study outcomes were extracted. The quality and risk of bias were assessed using the Newcastle-Ottawa Scale.

Data synthesis: The pooled relative risks (RR) with 95% confidence intervals (CI) were obtained with a random-effects model and results presented as forest plots. Heterogeneity and sensitivity analysis were assessed.

Results: Shorter sleep duration (less than or equal to 6 h) was associated with a higher risk for (ACM) (RR: 1.16, 95% CI: 1.11 -1.22) and CVDM (RR: 1.26, 95% CI: 1.12 -1.41) compared to 7-8 h of sleep, with no significant heterogeneity. The association between longer sleep (greater than or equal to 8 h) and ACM (RR: 1.18, 95% CI:1.12 -1.23, P < 0.001) needs to be interpreted cautiously owing to high heterogeneity
(I2 ¼ 86.0%, P < 0.001).

Conclusion: Interventions and education programs targeting sleep health in the workplace may be warranted, based on our findings that employed individuals who report shorter sleep appear to have a higher risk for ACM and CVDM.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: No
Item Status: Live Archive
Faculty/School / Institute/Centre: Historic - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing (1 Jan 2015 - 31 Dec 2021)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 06 Apr 2021 07:20
Last Modified: 22 Sep 2021 04:44
Uncontrolled Keywords: sleep quantity, short sleep, heart disease, employed, workplace
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111712 Health Promotion
Fields of Research (2020): 42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified
Socio-Economic Objectives (2008): C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920505 Occupational Health
Socio-Economic Objectives (2020): 20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200507 Occupational health
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