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

Author:

Robinson Charlotte H1ORCID,Albury Charlotte2ORCID,McCartney David2,Fletcher Benjamin2,Roberts Nia3,Jury Imogen1,Lee Joseph2

Affiliation:

1. Department of Medical Sciences, University of Oxford, Oxford, UK

2. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

3. Bodleian Health Care Libraries, University of Oxford, Oxford, UK

Abstract

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.

Funder

National Institute for Health Research

Publisher

Oxford University Press (OUP)

Subject

Family Practice

Reference42 articles.

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