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. 2021 Feb 18:12:646342.
doi: 10.3389/fpsyt.2021.646342. eCollection 2021.

Prevalence of Sleep Disturbances and Sleep Quality in Chinese Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Lei Xia  1 , Changhao Chen  2 , Zhiqiang Liu  3 , Xiangfen Luo  1   4 , Chunyan Guo  3 , Zhiwei Liu  5 , Kai Zhang  1 , Huanzhong Liu  1
Affiliations

Prevalence of Sleep Disturbances and Sleep Quality in Chinese Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Lei Xia et al. Front Psychiatry. .

Abstract

Objectives: Healthcare workers (HWs) experienced high levels of work stress during the COVID-19 pandemic, leading to a high risk of sleep disturbances. This meta-analysis aimed to explore the prevalence of sleep disturbances and sleep quality in Chinese HWs during the COVID-19 pandemic. Methods: English (PubMed, EMBASE, PsycINFO, Web of Science, and the Cochrane Library) and Chinese databases (WanFang, Chinese National Knowledge Infrastructure, and SinoMed) were systematically and independently searched for relevant studies published from December 1, 2019, to May 20, 2020. The pooled prevalence of sleep disturbances and sleep quality were calculated using a random-effects model. Results: A total of 17 studies involving 12,682 Chinese HWs were included in the meta-analysis. The pooled prevalence of sleep disturbances in Chinese HWs was 45.1% (95% CI: 37.2-53.1%). We found that the prevalence of sleep disturbances varied among frontline, infected, and non-frontline HWs (Q = 96.96, p < 0.001); females and males (Q = 9.10, p = 0.003); studies using different assessment instruments (Q = 96.05, p < 0.001); and studies with different sample sizes (Q = 5.77, p = 0.016) and cut-off values (Q = 62.28, p < 0.001). The pooled mean total score of the Pittsburgh Sleep Quality Index (PSQI) was 9.83 (95% CI: 8.61-11.04). HWs in Wuhan had a higher total PSQI score than those in other regions (Q = 9.21, p = 0.002). Conclusion: Sleep disturbances were common in Chinese HWs during the COVID-19 pandemic, particularly in frontline and infected HWs. Our results indicate the heavy mental health burden on HWs during the COVID-19 pandemic in China and can provide other countries with valuable information to assist HWs during the crisis.

Keywords: COVID-19; China; healthcare workers; meta-analysis; sleep disturbances.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study selection process.
Figure 2
Figure 2
Forest plot of the prevalence of sleep disturbances in Chinese healthcare workers.
Figure 3
Figure 3
Forest plot of the mean total score of the PSQI.
Figure 4
Figure 4
Funnel plot of publication bias for the prevalence of sleep disturbances.
See this image and copyright information in PMC

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