title: Statins, mood, sleep, and physical function: a systematic review.
abstract: OBJECTIVE
  We aimed to evaluate the effects of statins on mood, sleep, and physical function.
  
  
  METHODS
  We performed a systematic computer-aided search of MEDLINE/PubMed, EMBASE, and the Cochrane Central Register and augmented this search by scrutinizing reference lists and making inquiries among colleagues and experts in the field. All patient populations and study types were considered. We selected studies of statin therapy compared with no statin or placebo. Outcome measures included mood, sleep, and physical function.
  
  
  RESULTS
  Thirty-four studies were included in qualitative synthesis. Seven of eight (88 %) observational studies, 4/6 (66 %) randomized trials with mood as a primary endpoint (487 total participants; exposure 4 weeks to 1 year), and 3/3 (100 %) randomized trials with mood as a secondary endpoint (2,851 total participants; exposure 1-4 years) were not compatible with a negative mood effect of statins. Comparatively, fewer studies examined statin effects on sleep and physical function. Studies reporting negative effects contained potential sources of bias, including multiple testing or lack of adjustment for confounders in observational studies, and failure to prespecify outcomes or report blinding in trials.
  
  
  CONCLUSIONS
  A limited body of available evidence is most compatible with no adverse effect of statins on quality of life measures, namely, mood, sleep, and physical function. Studies suggesting such effects suffer from an increased risk of bias. High-quality, prospective, and adequately powered studies are needed, especially in the domains of sleep and physical function, with careful attention to patients who may be most vulnerable to adverse effects.
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, 1800 Orleans Street, Zayed 7125, Baltimore, MD, 21287, USA.
authors.forename: Kristopher J
authors.initials: KJ
authors.lastname: Swiger
authors.forename: Raoul J
authors.initials: RJ
authors.lastname: Manalac
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
mesh_terms: D000339:Affect / Q000187:drug effects; D015982:Bias; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D009043:Motor Activity / Q000187:drug effects; D005082:Physical Exertion / Q000187:drug effects; D011788:Quality of Life; D012890:Sleep / Q000187:drug effects
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors