PONE-D-23-43503Sleep duration and hypertension incidence: Systematic review and meta-analysisPLOS ONE

Dear Dr. Soleimani,

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Mohammad Hossein Ebrahimi

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: 1. Title: The title should be more specific and concise, indicating the focus of the study. For example, "Association Between Sleep Duration and Hypertension Incidence: A Meta-Analysis."

2. Abstract:

• Method: Specify the statistical methods used for pooling hazard ratios and risk ratios (e.g., DerSimonian and Laird random-effects model).

• Results: Line 43 "Ranging from 2.4 to 18 years" might be better as "ranging from 2.4 to 18 years of follow-up duration."

• Conclusion: The conclusion should summarize the main findings of the study and their implications for clinical practice or further research.

3. Introduction:

• When discussing the association between sleep duration and HTN, it would be helpful to briefly mention some of the conflicting findings in the existing literature to highlight the need for the current study.

• The objectives of the study are clearly stated, but it might be beneficial to explicitly mention the primary aim of the meta-analysis (e.g., to quantify the association between sleep duration and HTN incidence) before discussing stratification by age and sex.

• Consider including a brief transition at the end of the introduction to smoothly lead into the methods section, such as mentioning the need for a systematic review and meta-analysis to address the existing uncertainties.

• Line 56-57: Consider rephrasing "With a worldwide prevalence estimated at 34% in men and 32% in women" to specify that these estimates pertain to the prevalence of hypertension.

4. Methods:

• Registration of Protocol: Specify whether the protocol was registered before the initiation of the study. Also, mention the publication date of the protocol if applicable.

• Clarify the rationale behind excluding studies with a sample size of less than 30 people.

• Line 127-129: Please provide references for the definitions of sleep duration utilized in the study.

• When discussing outcomes, providing examples of covariates used for adjustment could enhance understanding. Additionally, specify how missing data were handled during outcome extraction.

5. Discussion:

• Line 226-227: The statement "To our knowledge, this meta-analysis has been the most comprehensive study that exploring the relationship between sleep duration and HTN incidence" could be revised for clarity. For instance, you could say, "This meta-analysis represents a comprehensive investigation into the relationship between sleep duration and HTN incidence, encompassing various definitions of short and long sleep durations, as well as follow-up durations.

• While the discussion references previous meta-analyses and systematic reviews on the topic, it could be strengthened by providing a more detailed comparison of the current findings with those of previous studies. This would help contextualize the significance of the current study and highlight any novel contributions.

• When discussing the association between short sleep duration and HTN incidence, consider elaborating on the potential clinical implications of these findings. For example, you could discuss the importance of early detection and intervention for individuals with short sleep duration to reduce their risk of developing HTN.

• The limitations of the study are appropriately acknowledged in the discussion. To strengthen this section, consider providing a more detailed discussion of how these limitations may have influenced the results and interpretations. Additionally, discuss potential strategies to address these limitations in future research.

• The conclusion effectively summarizes the key findings of the study and emphasizes the implications for clinical practice and future research. To enhance the conclusion, consider reinforcing the main implications of the findings and providing recommendations for future research directions or public health interventions.

Reviewer #2: Hosseini et al. performed a systematic review and meta-analysis to assess the relationship between sleep duration and the risk of incident HTN. I have several minor and major comments for revision:

ABSTRACT

* Please highlight the comparison group in your methods.

* Try to use "risk" before using "incidence" of HTN throughout the manuscript.

* Use pooled "RR" instead of pooled "HR" throughout the manuscript, as you are combining different types of association measures.

INTRODUCTION

* Please state the clinical impressions of your study in the last paragraph of the Introduction. What problems remain unanswered? What are questions responding to?

METHODS

* Please check for consistency with the PRISMA guideline!

* Explain your methods in more detail! How many reviewers contributed to different processes? You should also cite references regarding heterogeneity, Egger's test, etc.

* The NOS assessed quality or risk of bias? These are different!

RESULTS

* Table 1 is not observed completely!

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Reviewer #1: Yes: Faizul Akmal bin Abdul Rahim

Reviewer #2: No

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Association between sleep duration and hypertension incidence: Systematic review and meta-analysis of cohort studies

PONE-D-23-43503R1

Dear Dr. Soleimani,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Mohammad Hossein Ebrahimi

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

Reviewer #4: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: (No Response)

Reviewer #3: Yes

Reviewer #4: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Thanks for your revisions. All comments have been addressed. Your revised manuscript is acceptable now.

Reviewer #3: The manuscript is rather interesting and novel. Well presented and statistical analysis was adequate.

The association between sleep duration and hypertension is clinically significant and short duration of sleep was associated

As expected with increased incidence of htn. The results should be published.

Reviewer #4: Manuscript has been published in JACC already: SLEEP DURATION AND HYPERTENSION INCIDENCE: SYSTEMATIC REVIEW AND META-ANALYSIS

OPEN ACCESS

Prevention And Health Promotion

Aayushi Sood, Kaveh Hosseini, Hamidreza Soleimani, Kiarash Tavakoli, Narges Heydari, Yasmim Fravash, Mani Khorsand Askari, Akshit Sood, Kimia Najafi, Rahul Gupta, Kazem Rahimi, and Diaa A. Hakim

J Am Coll Cardio. 2024 Apr, 83 (13_Supplement) 1877

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: Yes: Dimitrios Afendoulis

Reviewer #4: No

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