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To systematically examine the association between sleep duration and metabolic syndrome (Mets) risk in cross-sectional and prospective cohort studies. Methods Data were collected from 36 cross-sectional and 9 longitudinal studies with a total of 164799 MetS subjects and 430895 controls. Odds ratios (ORs) for MetS in cross-sectional studies and risk ratios (RRs) for incident MetS were calculated through meta-analyses of adjusted data from individual studies. Subgroup analyses were performed to investigate the association between MetS and the duration of short-and-long sleep. Results Short sleep duration was significantly associated with increased prevalent MetS (OR= 1.11, 95% CI =1.05-1.18) and incident MetS (RR= 1.28, 95% CI =1.07-1.53,) in cross-sectional and longitudinal studies, respectively. Furthermore, long sleep duration was significantly associated with increased prevalent MetS in cross-sectional studies (OR= 1.14, 95% CI =1.05-1.23), rather than incident MetS (RR= 1.16, 95% CI =0.95-1.41) in longitudinal studies. Interestingly, the association between long sleep and prevalent MetS was found in sleep duration defined by 24-hour sleep (including naps) rather than nighttime sleep. In cross-sectional studies, pooled odds for MetS were 1.36 (95% CI=1.04-1.78, I2=83.3%) in ≤ 5 hours, 1.09 (95% CI=1.02-1.16, I2=67.8%) in ≤6 hours, 1.01 (95% CI=0.93-1.10, I2=24.9%) in &amp;lt;7 hours, 1.11 (95% CI=1.02-1.21, I2=67.0%) in ≥9 hours and 1.31 (95% CI=1.22-1.40, I2=0%) in ≥10 hours, respectively. The association of short sleep and MetS was stronger in young and middle age adults, but lost in adults age &amp;gt;60 years. Conclusion Our findings suggest 1) a “U-shape” relationship between sleep duration and MetS in cross-sectional studies and 2) association between short sleep duration, but not long sleep duration with incident MetS. Future studies should shed light on the underlying mechanisms related to the association between sleep duration and MetS and examine if normalizing sleep duration reduces MetS risk in the general population. Support This study was supported by National Natural Science Foundation of China (No. 81600068 &amp; 81970087), the Young Elite Scientists Sponsorship Program by CAST (No. YESS20160072), Medical Science Foundation of Guangdong Provence (A2018296) and Grant for Key Disciplinary Project of Clinical Medicine under the Guangdong High-level University Development Program.

1035 Sleep Duration and Metabolic Syndrome: An Updated Systematic Review and Meta-Analysis