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

source extracted confidence: high 2026-04-09
#humans #sleep-initiation-and-maintenance-disorders #lung-neoplasms #sleep-wake-disorders #sleep

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

Zhou et al., 2023 | BMC Cancer | Meta Analysis

Citation

Zhou Tong, Wang Zichen, ... Hou Wei. Sleep disturbances and the risk of lung cancer: a meta-epidemiological study. BMC Cancer. 2023-Sep-19;23(1):884. doi:10.1186/s12885-023-11392-2

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.

Key Findings

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

Outcomes Measured

  • sleep duration
  • inflammatory markers

Population

Field Value
Population See abstract
Sample Size 469691
Age Range See abstract
Condition insomnia

MeSH Terms

  • Humans
  • Sleep Initiation and Maintenance Disorders
  • Lung Neoplasms
  • Sleep Wake Disorders
  • Sleep
  • Epidemiologic Studies

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Systematic Review, Meta-Analysis, Journal Article
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09