睡眠障碍与肺癌之间的关系复杂且双向性。本次荟萃流行病学研究旨在探讨睡眠紊乱与肺癌风险之间的潜在关联。我们对PubMed、Embase、Cochrane Library和Web of Science数据库进行了全面的文献搜索，以获取相关研究。我们采用纽卡斯尔-奥塔华评分来评估观察性研究的质量。采用Stata 17.0软件综合和进行了奥尔斯比率（OR）和相应95％置信区间（CI）的荟萃分析。我们使用漏斗图分析和Egger回归检验评估潜在的出版偏倚现象。总共包括469,691名参与者的11项研究。被纳入研究的研究的方法学质量从中等到高。与7-8小时的睡眠时间相比，较短的睡眠时长与肺癌风险增加13％有关[OR, 1.13; 95％CI: 1.02-1.25; I2 = 67.6%; P = 0.018]，而较长的睡眠时长与风险增加22％有关[OR, 1.22; 95％CI: 1.12-1.33; I2 = 6.9%; P < 0.001]。失眠症状[OR, 1.11; 95％CI: 1.07-1.16; I2 = 0%; P < 0.001]和晚间类型[OR, 1.15; 95％CI: 1.05-1.26; P = 0.002]与肺癌风险增加有关。Egger检验显示睡眠时长不存在出版偏倚（P = 0.13）。本次系统回顾是观察到睡眠障碍和肺癌发病率之间存在积极关联的首个研究。尽管其可行机制尚不清楚，但研究假设短睡眠时长和肺癌的关联主要通过褪黑素分泌和免疫-炎症平衡介导。进一步的研究需要检查其他风险因素，如年龄、职业、睡眠障碍的累积效应是否介导睡眠障碍与肺癌风险之间的关系。本研究发现，睡眠时长不足和过长、失眠症状和晚间类型明显预测肺癌风险的增加。这一发现强调了在评估对肺癌易感性时考虑睡眠障碍作为独立风险因素的必要性。CRD42023405351.© 2023. BioMed Central Ltd., part of Springer Nature.

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.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.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).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.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.CRD42023405351.© 2023. BioMed Central Ltd., part of Springer Nature.