Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

Abstract

This systematic review and meta-analysis evaluated the extent of sleep disturbances during the COVID-19 pandemic. Eleven databases and six preprint repositories were searched for the period from November 1, 2019, to July 15, 2021. The DerSimonian and Laird method was used to develop random-effect meta-analyses. Two hundred and fifty studies comprising 493,475 participants from 49 countries were included. During COVID-19, the estimated global prevalence of sleep disturbances was 40.49% [37.56; 43.48%]. Bayesian meta-analysis revealed an odds of 0.68 [0.59; 0.77] which translates to a rate of approximately 41%. This provides reassurance that the estimated rate using classical meta-analysis is robust. Six major populations were identified; the estimated prevalence of sleep problem was 52.39% [41.69; 62.88%] among patients infected with COVID-19, 45.96% [36.90; 55.30%] among children and adolescents, 42.47% [37.95; 47.12%] among healthcare workers, 41.50% [32.98; 50.56%] among special populations with healthcare needs, 41.16% [28.76; 54.79%] among university students, and 36.73% [32.32; 41.38%] among the general population. Sleep disturbances were higher during lockdown compared to no lockdown, 42.49% versus 37.97%. Four in every ten individuals reported a sleep problem during the COVID-19 pandemic. Patients infected with the disease, children, and adolescents appeared to be the most affected groups.

Dreaming during the COVID-19 pandemic: A narrative review

“…Furthermore, several findings suggest that a greater electrophysiological desynchronization promotes dream recall ( Scarpelli et al, 2017 , Scarpelli et al, 2020 , Siclari et al, 2017 , Siclari et al, 2018 ). The pandemic had a strong and complex impact on sleep ( Partinen et al, 2021 , Cellini et al, 2020 , Franceschini et al, 2020 , Alfonsi et al, 2021 , Morin et al, 2021 , Gorgoni et al, 2021b , Gorgoni et al, 2021c , Salfi et al, 2021 ), more frequently in the direction of a worse sleep quality ( Jahrami et al, 2021 , Jahrami et al, 2022 ). Therefore, it is possible that the increased frequency and intensity of the oneiric activity during the pandemic may be at least in part a consequence of greater arousal during sleep associated with the frequent reduction of sleep quality, which would facilitate the process of dream encoding and recall.…”

Sleep quality and patterns of young West Balkan adults during the third wave of COVID-19 pandemic: a cross-sectional study

“…Epidemiological measures have been linked to sleep disturbances12 and also to an increase in substance abuse as a form of coping mechanism which further affects sleep architecture, potentially exacerbating sleep pathologies and worsening daytime sleepiness 13. Furthermore, individuals with pre-existing mental health conditions, such as depression and anxiety, may be at higher risk of worsened mental health which may lead to difficulty going to and maintaining sleep, daytime drowsiness and nightmares 14…”

Translation, validity and reliability of the Danish version of the Adolescent Insomnia Questionnaire

“…Indeed, in our sample most adolescents were recruited through a Facebook post, which might have attracted adolescents with severe symptoms of insomnia. In addition, a recent meta-analysis showed a high prevalence of sleep disturbances, especially in children and adolescents (46% prevalence) during the COVID-19 pandemic (Jahrami et al, 2022), which is the period when online recruitment occurred. This might have increased the prevalence of insomnia symptoms in the sample"…”

“…"Finally, adolescence is a period where changes in bedtime occur due to both biological and social factors 7 , which, together with the effect of the inborn chronotype, might result in a social jetlag and consequential reduced sleep duration 32 . Therefore, future studies should also try to measure the social jetlag that the adolescent might be experiencing.…”