The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index.
Epidemiological evidence for the link between sleep duration and high blood pressure: A systematic review and meta-analysis
Abstract
Objectives We aim to assess if the relationship between short or long sleep duration and hypertension is present among adults from epidemiological evidence and to investigate the relationship quantitatively.Methods We performed a comprehensive search of cross-sectional and longitudinal studies using PubMed and the Cochrane Library through February 2012. Our search was supplemented by reviewing reference lists of original and relevant reviews. After the related data were extracted by two investigators independently, pooled odds ratios (ORs) or relative risks (RRs) were estimated using a random-effects model or a fixed-effects model. Publication bias was evaluated, while sensitivity and meta-regression analyses were performed.Results Twenty-four adult studies met our inclusion criteria, with ages ranging from 18 to 106 years. Twenty-one studies involving 225,858 subjects were included in the meta-analysis. The pooled results from the cross-sectional studies showed that short sleep duration was associated with a greater risk for hypertension (OR, 1.21; 95% confidence interval [CI], 1.09-1.34; P<0.001), and long sleep duration also increased the risk for hypertension (OR, 1.11; 95% CI, 1.04-1.18; P=0.003). There was no evidence of publication bias. Pooled analysis from the longitudinal studies indicated a significant association between short sleep duration and hypertension (RR, 1.23; 95% CI, 1.06-1.42; P=0.005), but an insignificant relationship between long sleep duration and hypertension (RR, 1.02; 95% CI, 0.91-1.14; P=0.732). The effects of sleep duration differed by gender, location of the population, and definitions of short or long sleep duration. Meta regression analysis including seven variables did not find the sources of heterogeneity.Conclusions Among adults, a U-shaped relationship between habitual sleep duration and hypertension was found at the cross-sectional level. Short sleep duration was associated with a higher risk for hypertension even longitudinally. We must pay more attention to this lifestyle factor.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“In contrast, another meta-analysis found an association between both short and long sleep and hypertension in cross-sectional studies, but only for short sleep in longitudinal studies.63”
In the citing paper
“Two showed similar results without evidence of heterogeneity (RR=1.21; 95% CI, 1.05–1.40 based on 6 studies94; and RR=1.23; 95% CI, 1.06–1.42 based on 5 studies95).”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [95]
In the citing paper
“A substantial body of evidence indicates that lower quality or quantity of sleep is linked to poorer physical health,20–22 including elevated risks for cardiovascular disease,23 hypertension,24 and early mortality.25”
From Social Media Use and Its Link to Physical Health Indicators (2022) · cites this paper as [22]
In the citing paper
“In contrast, another meta-analysis found an association between both short and long sleep and hypertension in cross-sectional studies, but only for short sleep in longitudinal studies.63”
In the citing paper
“The relationship between self-reported sleep duration and prevalent hypertension follows a U-shaped association with the nadir of the U being between 7 and 8 hours of uninterrupted sleep per night.256,264,265”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [265]
Citations
Cites
World Health Organization, I. S. O. H. W. G. (2003) · Journal of Hypertension · doi:10.1097/00004872-200311000-00002 · Cited by 2,662
Spiegel, K., Tasali, E., Penev, P., & Cauter, E. V. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-11-200412070-00008 · Cited by 2,459
Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies
Cappuccio, F. P., D'Elia, L., Strazzullo, P., & Miller, M. A. (2010) · Sleep · doi:10.1093/sleep/33.5.585 · Cited by 2,224
Cappuccio, F. P., Cooper, D., D'Elia, L., Strazzullo, P., & Miller, M. A. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr007 · Cited by 2,146
Meta-Analysis of Short Sleep Duration and Obesity in Children and Adults
Cappuccio, F. P., Taggart, F. M., Kandala, N.-B., Currie, A., Peile, E., Stranges, S., & Miller, M. A. (2008) · Sleep · doi:10.1093/sleep/31.5.619 · Cited by 2,076
Quantity and Quality of Sleep and Incidence of Type 2 Diabetes
Cappuccio, F. P., D'Elia, L., Strazzullo, P., & Miller, M. A. (2010) · Diabetes Care · doi:10.2337/dc09-1124 · Cited by 1,670
Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999–2004
Ong, K. L., Cheung, B. M. Y., Man, Y. B., Lau, C. P., & Lam, K. S. L. (2007) · Hypertension · doi:10.1161/01.hyp.0000252676.46043.18 · Cited by 1,395
Gangwisch, J. E., Heymsfield, S. B., Boden-Albala, B., Buijs, R. M., Kreier, F., Pickering, T. G., Rundle, A. G., Zammit, G. K., & Malaspina, D. (2006) · Hypertension · doi:10.1161/01.hyp.0000217362.34748.e0 · Cited by 1,284
Association of usual sleep duration with hypertension: the Sleep Heart Health Study
Gottlieb, D. J., Redline, S., Nieto, F. J., Baldwin, C. M., Newman, A. B., Resnick, H. E., & Punjabi, N. M. (2006) · Sleep · doi:10.1093/sleep/29.8.1009 · Cited by 947
Buxton, O. M., & Marcelli, E. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.05.041 · Cited by 818
Insomnia with Objective Short Sleep Duration is Associated with a High Risk for Hypertension
Vgontzas, A. N., Liao, D., Bixler, E. O., Chrousos, G. P., & Vela-Bueno, A. (2009) · Sleep · doi:10.1093/sleep/32.4.491 · Cited by 748
Comparison between subjective and actigraphic measurement of sleep and sleep rhythms
Lockley, S. W., Skene, D. J., & Arendt, J. (1999) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1999.00155.x · Cited by 622
An epidemiological study of insomnia among the Japanese general population
Kim, K., Uchiyama, M., Okawa, M., Liu, X., & Ogihara, R. (2000) · Sleep · doi:10.1093/sleep/23.1.1a · Cited by 524
Ferrie, J. E., Shipley, M. J., Cappuccio, F. P., Brunner, E., Miller, M. A., Kumari, M., & Marmot, M. G. (2007) · Sleep · doi:10.1093/sleep/30.12.1659 · Cited by 515
Cappuccio, F. P., Stranges, S., Kandala, N.-B., Miller, M. A., Taggart, F. M., Kumari, M., Ferrie, J. E., Shipley, M. J., Brunner, E. J., & Marmot, M. G. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.095471 · Cited by 512
Correlates of Long Sleep Duration
Patel, S. R., Malhotra, A., Gottlieb, D. J., White, D. P., & Hu, F. B. (2006) · Sleep · doi:10.1093/sleep/29.7.881 · Cited by 490
Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension
Scheer, F. A. J. L., Van Montfrans, G. A., van Someren, E. J. W., Mairuhu, G., & Buijs, R. M. (2004) · Hypertension · doi:10.1161/01.hyp.0000113293.15186.3b · Cited by 451
JACC Study Group (2004) · SLEEP · doi:10.1093/sleep/27.1.51 · Cited by 449
Self-Reported Sleep Duration is Associated with the Metabolic Syndrome in Midlife Adults
Hall, M. H., Muldoon, M. F., Jennings, J. R., Buysse, D. J., Flory, J. D., & Manuck, S. B. (2008) · Sleep · doi:10.1093/sleep/31.5.635 · Cited by 447
Who are the long sleepers? Towards an understanding of the mortality relationship
Grandner, M. A., & Drummond, S. P. A. (2007) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2007.03.010 · Cited by 432
Association Between Sleep and Blood Pressure in Midlife: The CARDIA Sleep Study
Knutson, K. L., Van Cauter, E., Rathouz, P. J., Yan, L. L., Hulley, S. B., Liu, K., & Lauderdale, D. S. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.119 · Cited by 403
Heslop, P., Smith, G. D., Metcalfe, C., Macleod, J., & Hart, C. (2002) · Sleep Medicine · doi:10.1016/s1389-9457(02)00016-3 · Cited by 335
Effects of insufficient sleep on blood pressure in hypertensive patients: a 24-h study
Lusardi, P. (1999) · American Journal of Hypertension · doi:10.1016/s0895-7061(98)00200-3 · Cited by 331
BJORVATN, B., SAGEN, I. M., ØYANE, N., WAAGE, S., FETVEIT, A., PALLESEN, S., & URSIN, R. (2007) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2007.00569.x · Cited by 320
How do individuals sleep around the world? Results from a single-day survey in ten countries
Soldatos, C. R., Allaert, F., Ohta, T., & Dikeos, D. G. (2004) · Sleep Medicine · doi:10.1016/j.sleep.2004.10.006 · Cited by 317
Meisinger, C., Heier, M., Löwel, H., Schneider, A., & Döring, A. (2007) · Sleep · doi:10.1093/sleep/30.9.1121 · Cited by 305
Epidemiological evidence for the links between sleep, circadian rhythms and metabolism
Gangwisch, J. E. (2009) · Obesity Reviews · doi:10.1111/j.1467-789x.2009.00663.x · Cited by 269
Ogawa, Y., Kanbayashi, T., Saito, Y., Takahashi, Y., Kitajima, T., Takahashi, K., Hishikawa, Y., & Shimizu, T. (2003) · SLEEP · doi:10.1093/sleep/26.8.986 · Cited by 235
Sleep and the metabolic syndrome
Wolk, R. A., & Somers, V. K. (2006) · Experimental Physiology · doi:10.1113/expphysiol.2006.033787 · Cited by 193
Role of sleep-wake cycle on blood pressure circadian rhythms and hypertension
Smolensky, M. H., Hermida, R. C., Castriotta, R. J., & Portaluppi, F. (2007) · Sleep Medicine · doi:10.1016/j.sleep.2006.11.011 · Cited by 192
Lusardi, P. (1996) · American Journal of Hypertension · doi:10.1016/0895-7061(95)00389-4 · Cited by 183
Bansil, P., Kuklina, E. V., Merritt, R. K., & Yoon, P. W. (2011) · The Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2011.00500.x · Cited by 180
Stranges, S., Dorn, J. M., Cappuccio, F. P., Donahue, R. P., Rafalson, L. B., Hovey, K. M., Freudenheim, J. L., Kandala, N., Miller, M. A., & Trevisan, M. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e328335d076 · Cited by 179
Choi, K. M., Lee, J. S., Park, H. S., Baik, S. H., Choi, D. S., & Kim, S. M. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.62 · Cited by 169
Sedentary Behaviors and the Risk of Incident Hypertension * The SUN Cohort
Beunza, J. J., Martínez‐González, M. Á., Ebrahim, S. B. J., Bes‐Rastrollo, M., Núñez, J. H., Martínez, J. A., & Alonso, Á. (2007) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2007.06.007 · Cited by 164
Zheng, L., Sun, Z., Li, J., Zhang, R., Zhang, X., Liu, S., Li, J., Xu, Z., Hu, D., & Sun, Y. (2008) · Stroke · doi:10.1161/strokeaha.107.510677 · Cited by 161
Self-citationSleep measurement in flight crew: comparing actigraphic and subjective estimates to polysomnography.
Signal, T. L., Gale, J., & Gander, P. H. (2005) · PubMed · Cited by 160
Association of Sleep Duration and Hypertension Among US Adults Varies by Age and Sex
Fang, J., Wheaton, A. G., Keenan, N. L., Greenlund, K. J., Perry, G., & Croft, J. B. (2011) · American Journal of Hypertension · doi:10.1038/ajh.2011.201 · Cited by 136
Magee, C., Kritharides, L., Attia, J., McElduff, P., & Banks, E. (2011) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2011.00993.x · Cited by 117
Sleep duration and hypertension are not associated in the elderly
van den Berg, J. F., Tulen, J. H. M., Neven, A. K., Hofman, A., Miedema, H. M. E., Witteman, J. C. M., & Tiemeier, H. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.092585 · Cited by 117
Age-Dependent Association Between Sleep Duration and Hypertension in the Adult Korean Population
Kim, J., & Jo, I. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.166 · Cited by 110
Liang, Y.-J., Xi, B., Hu, Y.-H., Wang, C., Liu, J.-T., Yan, Y.-K., Xu, T., & Wang, R.-Q. (2011) · Blood Pressure · doi:10.3109/08037051.2010.524085 · Cited by 107
Self‐Reported Sleep Duration and Hypertension in Older Spanish Adults
López‐García, E., Faubel, R., Guallar‐Castillón, P., León-Muñoz, L. M., Banegas, J. R., & Rodríguez‐Artalejo, F. (2009) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2009.02177.x · Cited by 60
Sun, Z., Zheng, L., Xu, Z., Li, J., Zhang, X., Liu, S., Li, J., Hu, D., & Sun, Y. (2007) · International Journal of Cardiology · doi:10.1016/j.ijcard.2007.08.127 · Cited by 56
Self-citationMoore, W. E., Eichner, J. E., Cohn, E. M., Thompson, D. M., Kobza, C., & Abbott, K. E. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2009.13 · Cited by 52
Gender-specific associations of short sleep duration with prevalent hypertension
Stang, A., Moebus, S., Möhlenkamp, S., Erbel, R., & Jöckel, K. H. (2008) · Hypertension · doi:10.1161/hypertensionaha.107.108456 · Cited by 51
Dean, E., Bloom, A., Cirillo, M., Hong, Q., Jawl, B., Jukes, J., Nijjar, M., Sadovich, S., & Bruno, S. (2011) · Blood Pressure · doi:10.3109/08037051.2011.596320 · Cited by 40
Kim, S. J., Lee, S. K., Kim, S. H., Yun, C.-H., Kim, J. H., Thomas, R. J., & Shin, C. (2012) · Circulation Journal · doi:10.1253/circj.cj-11-0713 · Cited by 39
Lima-Costa, M. F., Peixoto, S. V., & Rocha, F. L. (2008) · Sleep Medicine · doi:10.1016/j.sleep.2007.09.005 · Cited by 37
Gender-specific association of sleep duration with blood pressure in rural Chinese adults
Wang, H., Zee, P. C., Reid, K. J., Chervin, R. D., Patwari, P. P., Wang, B., Li, Z., Tang, G., Liu, X., Yang, J., et al. (2011) · Sleep Medicine · doi:10.1016/j.sleep.2010.12.019 · Cited by 35
Relationship between sleep duration and clustering of metabolic syndrome diagnostic components
Nakamura, Y., Katano, Nakamura, Murakami, Y., Tanaka, T., Takebayashi, T., Okayama, A., Miura, K., Okamura, & Ueshima, H. (2011) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s16147 · Cited by 30
Factors Related to Elevated 24-h Blood Pressure in Young Adults
Fujikawa, T., Tochikubo, O., Kura, N., & Umemura, S. (2009) · Clinical and Experimental Hypertension · doi:10.3109/10641960903254422 · Cited by 20
Components of the Metabolic Syndrome and Lifestyle Factors in Japanese Male Workers
Kawada, T., Okada, K., & Amezawa, M. (2008) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2008.0020 · Cited by 18
Flagged first, then by citations
Cited by
Sorted by citations
Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression
Itani, O., Jike, M., Watanabe, N., & Kaneita, Y. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2016.08.006 · Cited by 1,252
Health consequences of shift work and insufficient sleep
Kecklund, G., & Axelsson, J. (2016) · BMJ · doi:10.1136/bmj.i5210 · Cited by 1,195
Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153
St-Onge, M.-P., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., & Bhatt, D. L. (2016) · Circulation · doi:10.1161/cir.0000000000000444 · Cited by 1,044
Panel, C. C., Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., et al. (2015) · Sleep · doi:10.5665/sleep.4886 · Cited by 906
Metadata
- Authors
- Guo, X., Zheng, L., Wang, J., Zhang, X., Zhang, X., Li, J., & Sun, Y.
- Affiliations
- First Hospital of China Medical University (CN)
- Sheng Jing Hospital (CN)
- Tongji University (CN)
- Corresponding author
- Sun, Yingxian
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 14
- Issue
- 4
- Pages
- 324-332
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W1969887065
- Cited by
- 327
- References
- 54
- Citations by year
- 2026: 5 · 2025: 34 · 2024: 30 · 2023: 24 · 2022: 21 · 2021: 31 · 2020: 21 · 2019: 29 · 2018: 27 · 2017: 25 · 2016: 23 · 2015: 21 · 2014: 29 · 2013: 6
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- sleep duration, hypertension, short sleep duration, long sleep, U-shaped relationship, cardiovascular risk factors, lifestyle factors, adults
- MeSH terms
- Blood Pressure, Humans, Hypertension, Sleep, Sleep Wake Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
