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BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Lung Cancer | Research

Sleep disturbances and the risk of lung cancer: a meta-epidemiological study

Authors: Tong Zhou, Zichen Wang, Chenxi Qiao, Shuo Wang, Shuaihang Hu, Xinyan Wang, Xiumei Ma, Dandan Wang, Jinglei Li, Zheng Li, Wei Hou

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

The relationship between sleep disturbances and lung cancer is complex and bidirectional. This meta-epidemiological study aimed to explore the potential association between sleep disruption and the risk of pulmonary cancer.

Methods

We conducted a comprehensive literature search of the PubMed, Embase, Cochrane Library, and Web of Science databases to retrieve relevant studies. We employed the Newcastle–Ottawa Scale to assess the quality of the observational studies. Stata 17.0 was used to synthesize and conduct a meta-analysis of odds ratios (ORs) and corresponding 95% confidence intervals (CIs). We used funnel plot analysis and Egger’s regression test to evaluate potential publication bias.

Results

A total of 11 studies were included with 469,691 participants. The methodological quality of the included studies ranged from moderate to high. Compared with 7–8 h of sleep time, short sleep duration was associated with a 13% higher lung cancer risk [OR, 1.13; 95%CI: 1.02–1.25; I2 = 67.6%; P = 0.018] and long sleep duration with a 22% higher risk [OR, 1.22; 95%CI: 1.12–1.33; I2 = 6.9%; P < 0.001]. Insomnia symptoms [OR, 1.11; 95%CI: 1.07–1.16; I2 = 0%; P < 0.001] and evening chronotype [OR, 1.15; 95%CI: 1.05–1.26; P = 0.002] were all related to a higher risk of lung cancer. Egger’s test revealed no publication bias for sleep duration (P = 0.13).

Discussion

This systematic review is the first one which observes positive correction between sleep disturbances and the incidence of lung cancer. While the plausible mechanism is not clear, it is hypothesized that the association of short sleep duration and lung cancer mainly mediated by melatonin secretion and the immune-inflammatory balance. Further studies are needed to examine whether other risk factors, such as age, occupation, cumulative effect of sleep disturbances might mediate the relationship between sleep disturbances and lung cancer risk.

Conclusion

The present study revealed that insufficient and excessive sleep duration, insomnia symptoms, and evening chronotype were significantly predictive of an increased risk of lung cancer. This finding underscores the need to account for sleep disturbances as an independent risk factor for evaluating susceptibility to lung cancer.

Trial registration

CRD42023405351.
Appendix
Available only for authorised users
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Metadata
Title
Sleep disturbances and the risk of lung cancer: a meta-epidemiological study
Authors
Tong Zhou
Zichen Wang
Chenxi Qiao
Shuo Wang
Shuaihang Hu
Xinyan Wang
Xiumei Ma
Dandan Wang
Jinglei Li
Zheng Li
Wei Hou
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11392-2

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