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- Title
The relationship between duration and quality of sleep and upper respiratory tract infections: a systematic review.
- Authors
Robinson, Charlotte H; Albury, Charlotte; McCartney, David; Fletcher, Benjamin; Roberts, Nia; Jury, Imogen; Lee, Joseph
- Abstract
<bold>Background: </bold>Upper respiratory tract infections (URTIs) are common, mostly self-limiting, but result in inappropriate antibiotic prescriptions. Poor sleep is cited as a factor predisposing to URTIs, but the evidence is unclear.<bold>Objective: </bold>To systematically review whether sleep duration and quality influence the frequency and duration of URTIs.<bold>Methods: </bold>Three databases and bibliographies of included papers were searched for studies assessing associations between sleep duration or quality and URTIs. We performed dual title and abstract selection, discussed full-text exclusion decisions and completed 50% of data extraction in duplicate. The Newcastle-Ottawa Quality Assessment Scale assessed study quality and we estimated odds ratios (ORs) using random effects meta-analysis.<bold>Results: </bold>Searches identified 5146 papers. Eleven met inclusion criteria, with nine included in meta-analyses: four good, two fair and five poor for risk of bias. Compared to study defined 'normal' sleep duration, shorter sleep was associated with increased URTIs (OR: 1.30, 95% confidence interval [CI]: 1.19-1.42, I2: 11%, P < 0.001) and longer sleep was not significantly associated (OR: 1.11 95% CI: 0.99-1.23, I2: 0%, P = 0.070). Sensitivity analyses using a 7- to 9-hour baseline found that sleeping shorter than 7-9 hours was associated with increased URTIs (OR: 1.31, 95% CI: 1.22-1.41, I2: 0%, P < 0.001). Sleeping longer than 7-9 hours was non-significantly associated with increased URTIs (OR: 1.15, 95% CI: 1.00-1.33, I2: 0%, P = 0.050, respectively). We were unable to pool sleep quality studies. No studies reported on sleep duration and URTI severity or duration.<bold>Conclusions: </bold>Reduced sleep, particularly shorter than 7-9 hours, is associated with increased URTIs. Strategies improving sleep should be explored to prevent URTIs.
- Subjects
RESPIRATORY infections; SLEEP; INAPPROPRIATE prescribing (Medicine)
- Publication
Family Practice, 2021, Vol 38, Issue 6, p802
- ISSN
0263-2136
- Publication type
journal article
- DOI
10.1093/fampra/cmab033