To examine the longitudinal associations of sleep duration and sleep quality with coronary heart disease (CHD) risk among individuals aged ≥ 20 years. A systematic review and meta-analysis of observational cohort studies were performed to evaluate the association between sleep quality and duration, and the risk of CHD. We searched three databases including PUBMED, the Cochrane Library and EMBASE, selected relevant studies and used the classical and Net-work models to establish the hazard ratio (HRs) of the results. Data extracted from 11 studies including 769,452 participants and 14,769 patients with CHD events were reviewed. In the classical meta-analysis, night sleep duration of < 7 h and/or > 8 h showed an increased risk of CHD (HR = 1.13, and 1.13, respectively) compared with reference sleep (7–8 h). However, the net-work model stratified sleep quality into good and poor subgroups, and there was no change in CHD risk in each subgroup despite different sleep hours. Furthermore, individuals with poor-quality sleep were at a greater risk of CHD than those with good-quality sleep (HR = 1.4, 1.3, and 1.4 for < 7, 7–8, and > 8 h, respectively). Moreover, individuals with reference time sleep but that of poor quality were associated with an increased risk of CHD compared with good sleepers having short/long sleep duration (HR = 1.3 and 1.2, respectively). Poor-quality sleep was associated with great morbidity and mortality of CHD, independent of sleep duration. Sleep quality rather than sleep duration might be crucial for increased CHD risk, suggesting the potential importance of poor-quality sleep as a possible CHD risk factor.

在≥20岁的人群中检查睡眠时间和睡眠质量与冠心病（CHD）风险的纵向关联。对观察性队列研究进行了系统的回顾和荟萃分析，以评估睡眠质量和持续时间与冠心病风险之间的关系。我们搜索了三个数据库，包括PUBMED，Cochrane库和EMBASE，选择了相关研究，并使用经典模型和网络模型建立了结果的危险比（HRs）。回顾了11项研究的数据，包括769,452名参与者和14,769例CHD事件患者。在经典的荟萃分析中，与参考睡眠（7-8小时）相比，<7 h和/或> 8 h的夜间睡眠时间显示冠心病的风险增加（HR分别为1.13和1.13）。然而，网络模型将睡眠质量分为好和差两个亚组，尽管睡眠时间不同，每个亚组的CHD风险也没有变化。此外，睡眠质量差的人患CHD的风险比睡眠质量好的人（<7、7-8和> 8 h的HR分别为1.4、1.3和1.4）。此外，与睡眠时间短/长的良好睡眠者相比，具有参考时间睡眠但质量较差的个体与冠心病风险增加有关（HR分别为1.3和1.2）。睡眠质量差与冠心病的高发病率和死亡率相关，与睡眠时间无关。睡眠质量而不是睡眠时间可能是增加冠心病风险的关键，这表明低质量睡眠作为可能的冠心病危险因素的潜在重要性。