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Journal article

The relationship between duration and quality of sleep and upper respiratory tract infections: A systematic review

Abstract:

Background:
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.


Objective:
To systematically review whether sleep duration and quality influence the frequency and duration of URTIs.


Methods:
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.


Results:
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.


Conclusions:
Reduced sleep, particularly shorter than 7–9 hours, is associated with increased URTIs. Strategies improving sleep should be explored to prevent URTIs.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/fampra/cmab033

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
GLAM
Department:
Bodleian Libraries
Role:
Author


Publisher:
Oxford University Press
Journal:
Family Practice More from this journal
Volume:
38
Issue:
6
Pages:
802-810
Publication date:
2021-05-17
Acceptance date:
2021-03-17
DOI:
EISSN:
1460-2229
ISSN:
0263-2136


Language:
English
Keywords:
Pubs id:
1168808
Local pid:
pubs:1168808
Deposit date:
2021-03-19

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