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Meta-Analysis
. 2021 Feb 1;17(2):299-313.
doi: 10.5664/jcsm.8930.

Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis

Haitham Jahrami  1   2 , Ahmed S BaHammam  3   4 , Nicola Luigi Bragazzi  5 , Zahra Saif  1 , MoezAlIslam Faris  6 , Michael V Vitiello  7
Affiliations
Meta-Analysis

Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis

Haitham Jahrami et al. J Clin Sleep Med. .

Abstract

Study objectives: No systematic review or meta-analysis has yet been conducted to examine the impact of the pandemic on the prevalence of sleep problems among the general population, health care workers, or patients with COVID-19. Therefore, this systematic review was conducted to assess the impact and prevalence of sleep problems among those categories.

Methods: American Psychological Association PsycINFO, Cochrane, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, EMBASE, Google Scholar, MEDLINE, ProQuest Medical, ScienceDirect, Scopus, and Web of Science from November 1, 2019 to July 5, 2020 were used. Additionally, 5 preprints servers (medRxiv.org; preprints.org; psyarxiv.com; arXiv.org; biorxiv.org) were also searched for papers accepted after peer review but not yet published and indexed. There was no language restriction. The random-effect models meta-analysis model was used with the DerSimonian and Laird methodology.

Results: Forty-four papers, involving a total of 54,231 participants from 13 countries, were judged relevant and contributed to the systematic review and meta-analysis of sleep problems during COVID-19. The global pooled prevalence rate of sleep problems among all populations was 35.7% (95% confidence interval, 29.4-42.4%). Patients with COVID-19 appeared to be the most affected group, with a pooled rate of 74.8% (95% confidence interval, 28.7-95.6%). Health care workers and the general population had comparative rates of sleep problems, with rates of 36.0% (95% confidence interval, 21.1-54.2%) and 32.3% (95% confidence interval, 25.3-40.2%), respectively.

Conclusions: The prevalence of sleep problems during the COVID-19 pandemic is high and affects approximately 40% of people from the general and health care populations. Patients with active COVID-19 appeared to have a higher prevalence rates of sleep problems.

Keywords: circadian rhythm; insomnia; pandemic; sleep disturbance; sleep hygiene.

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Conflict of interest statement

All authors have seen and approved the manuscript. This article does not contain any studies with human participants performed by any of the authors. For this type of study (meta-analysis), formal consent is not required. The authors report no conflict of interest.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram of study inclusion.
Figure 2
Figure 2. Meta-analysis of the prevalence of sleep problems (all populations, all measures). Cases refer to persons with positive sleep problem.
Figure 3
Figure 3. Meta-analysis of the prevalence of sleep problems (all populations, PSQI only). Cases refer to persons with positive sleep problem. PSQI = Pittsburgh Sleep Quality Index.
Figure 4
Figure 4. Meta-analysis of mean global PSQI (all populations). PSQI = Pittsburgh Sleep Quality Index.
See this image and copyright information in PMC

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