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Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis
Open accessAbstract
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.
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“Moreover, students appear to exhibit worse sleep in the 5 weeks before their exams compared to the rest of the semester [83].”
From A systematic review and meta-analysis of poor sleep, insomnia symptoms and stress in undergraduate students (2022) · cites this paper as [83]
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“PSQI prevalence was also comparable to that in the general population during the outbreak determined using the same tool (Jahrami et al., 2021).”
From Long-term effects of COVID-19 on mental health: a systematic review (2022) · cites this paper as Jahrami et al., 2021
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Sleep patterns of US healthcare workers during the first wave of the COVID-19 pandemic
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The menstrual cycle and the COVID-19 pandemic
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“Around half the participants reported a reduction in sleep quality, quantity and difficulty falling asleep, which appears highly prevalent during the COVID-19 pandemic [53].”
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ResultInfluentialCOVID-19 pandemisi ve uyku bozuklukları: COVID-somnia
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Sleeping in a bubble: factors affecting sleep during New Zealand’s COVID-19 lockdown
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“Among the types of psychological suffering, pandemic-related sleep disorders have received much attention from public and mental health professionals worldwide [18,19].”
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“A recent meta-analysis showed a high prevalence of sleep problems [2], and sleep has been one of the top concerns during this pandemic period.”
BackgroundImpact of Screen Time During the Pandemic of COVID-19 on Sleep Habits
Boukhris, O. F., Jahrami, H., Trabelsi, K., Glenn, J. M., & Bragazzi, N. L. (2023) · Progress in Sleep Research · doi:10.1007/978-981-99-0240-8_17 · Cited by 11
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ALSHUMRANI, R. A., Qanash, S. A., Aldobyany, A., Alhejaili, F. F., AlQassas, I., Shabrawishi, M., Al-Nashiwaty, O., Badghaish, M., Adnan, M., Afeef, A. B., et al. (2022) · Annals of Thoracic Medicine · doi:10.4103/atm.atm_191_21 · Cited by 12
“6%).[12] They also concluded that the prevalence of sleep problems among the general population, comprising a total of 54,231 participants from 13 countries, was 32.”
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“First, most research regarding the association between COVID-19-related outcomes and sleep has addressed the unique challenges of data collection during the COVID-19 outbreak by utilizing surveys from a range of sources and/or by focusing on specific segments of certain populations.(22) In contrast, the present study…”
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“During this period approximately one third of previously good sleepers complained the occurrence of sleep disturbance across all continents [2, 3].”
BackgroundSleep Disorder During the Third Wave of COVID-19 Pandemic among Malaysian AdultsPreprint
Marzo, R. R., Shekhawat, K. S., Chauhan, S., Patel, R., Kyaw, T. M., Amran, B. B., bin Mat, M. A. I., Rajendiran, V. A. P., Noor, M. A. B. M., Acharya, S., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-596311/v1 · Cited by 11
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BackgroundSleep, Dreams, and Nightmares During the COVID-19 Pandemic
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“when contracting COVID-19,(10) and those diagnosed with COVID-19 have reported many sleep complaints.(11)”
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“…COVID-19 pandemic, a time of major crisis, the prevalence of sleep disturbances increased to approximately 40%, compared to pre-pandemic estimates of 25–30% (Bartlett et al., 2008; Gureje et al., 2011; Jahrami et al., 2021; LeBlanc et al., 2009; Morin et al., 2006, 2021; Perlis et al., 2020).”
BackgroundMascaro, L., Drummond, S. P. A., Leota, J., Boardman, J. M., Hoffman, D., Rajaratnam, S. M. W., Aidman, E., & Facer-Childs, E. R. (2023) · Frontiers in Physiology · doi:10.3389/fphys.2023.1118822 · Cited by 10
“In the general population, about one in three individuals experienced poor sleep or mental health during the pandemic (Jahrami et al., 2021; Wu et al., 2021).”
BackgroundAssociation of Pyridoxal 5′-Phosphate with Sleep-Related Problems in a General Population
Lin, G., Luo, J., Zhang, L., Kang, X., & Zhang, D. (2022) · Nutrients · doi:10.3390/nu14173516 · Cited by 10
“However, millions of people around the world suffer from sleep-related problems, especially with the COVID-19 pandemic bringing many new challenges to sleep problems [6,7].”
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“Emerging research shows that people have experienced increased sleep problems during the pandemic and associated these problems with increased psychological distress (Alimoradi et al., 2021; Jahrami et al., 2021).”
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“65,68 – 70 .”
Cohen, A., Haimov, I., & Szepsenwol, O. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.11.003 · Cited by 10
SARS-CoV-2 infection is associated with increased odds of insomnia, RLS and dream enactment behavior
Kumar, N., Goyal, A., Hussain, A., Saini, L. K., Chawla, O., Arora, P. K., Daga, R., Tikka, S. K., Goyal, S., Kanchan, S., et al. (2022) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_586_21 · Cited by 10
“[2] 6] A previous study from our group showed that the COVID-19 pandemic was associated with changes in circadian timing of sleep; however, prevalence of poor sleep quality remained unchanged.”
The impact of COVID-19 pandemic on sleep quality in healthcare workers in Turkey
Erdoğan, A., Tunçel, D., Öksüz, A. N., Şahin, A. R., & Koçyiğit, B. F. (2022) · The Egyptian Journal of Neurology Psychiatry and Neurosurgery · doi:10.1186/s41983-022-00489-3 · Cited by 10
“Moreover, inadequate and poor sleep affects the immune system and mental health, impairs the immune response, facilitates the spread of infectious diseases, and worsens mental health and quality of life [1, 11, 14].”
BackgroundLadis, I., Gao, C., & Scullin, M. K. (2022) · Psychology Health & Medicine · doi:10.1080/13548506.2022.2141281 · Cited by 12
“For instance, a recent meta-analysis showed that COVID-19 patients experience more sleep problems than both the general population and health care workers (Jahrami et al., 2021).”
BackgroundSleep Patterns and Sleep Alignment in Remote Teams during COVID-19
Breideband, T., Martinez, G. J., Sukumar, P. T., Caruso, M., D’Mello, S. K., Striegel, A., & Mark, G. J. (2022) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3555217 · Cited by 10
Tsaava, M., Oniani, N., Eliozishvili, M., Sakhelashvili, I., Tkemaladze, N., Aladashvili, T., Basishvili, T., & Darchia, N. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192316221 · Cited by 11
“Therefore, the study findings, in line with other studies, are suggestive of a higher vulnerability of younger individuals’ sleep quality to adverse consequences of the pandemic-related lockdowns [1,7,16,19].”
BackgroundResultBiofeedback as an Adjunct or Alternative Intervention to Cognitive Behavioral Therapy for Insomnia
Kremer, S., & Blue, T. (2023) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.10.003 · Cited by 11
Schamilow, S., Santonja, I., Weitzer, J., Strohmaier, S., Klösch, G., Seidel, S., Schernhammer, E. S., & Papantoniou, K. (2023) · Clocks & Sleep · doi:10.3390/clockssleep5030027 · Cited by 15
Radhakrishnan, A., Govindaraj, R., Sasidharan, A., Ravindra, P. N., Yadav, R., & Kutty, B. M. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2020.12.041 · Cited by 10
“7%); with CoVID-19 patients being the most affected group [18].”
BackgroundEfficacy, Safety, and Drug–Drug Interactions for Insomnia Therapy in COVID-19 Patients
Saputra, B. D., Levita, J., & Mustarichie, R. (2022) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s337053 · Cited by 10
“8%, followed by an increase in the use of sleeping pills.(6,7) Anti-insomnia drugs such as hypnotics, sedatives, and anxiolytics are the easiest option to treat insomnia.”
BackgroundBecerra, M. B., Gumasana, R. J., Mitchell, J. A., Truong, J. B., & Becerra, B. J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116900 · Cited by 10
“[17] noted a nearly 36% global pooled prevalence of reporting sleep problems, with the highest rate found among those with COVID-19.”
ResultMazza, C., Ricci, E., Colasanti, M., Cardinale, A., Bosco, F., Biondi, S., Tambelli, R., Di Domenico, A., Verrocchio, M. C., & Roma, P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010759 · Cited by 9
“In fact, one of the most consistent results was a negative effect on the quality of sleep [16–18]; indeed, a meta-analysis [19] on sleep problems during the COVID-19 outbreak indicated that approximately 40% of the general and healthcare populations were affected.”
ResultLiu, R. F., Qiu, Q., & Ye, B. (2024) · BMC Public Health · doi:10.1186/s12889-024-18684-7 · Cited by 12
Yupanqui-Lorenzo, D. E., Caycho‐Rodríguez, T., Baños-Chaparro, J., Arauco-Lozada, T., Palao-Loayza, L., Lobos-Rivera, M. E., Barrios, I., & Torales, J. C. (2024) · Psicologia Reflexão e Crítica · doi:10.1186/s41155-024-00312-3 · Cited by 9
Wollast, R., Lueders, A., Nugier, A., Guimond, S., Phillips, J. B., Sutton, R. M., Douglas, K. M., Sengupta, N. K., Lemay, E. P., Zand, S., et al. (2025) · Current Psychology · doi:10.1007/s12144-024-06989-0 · Cited by 10
“…symptoms (Ettman et al., 2020; Salari et al., 2020), increased loneliness (Buecker & Horstmann, 2021; Ernst et al., 2022), increased anxiety symptoms (Sal-ari et al., 2020), heightened general negative emotionality (Jahrami et al., 2021), and reduced sleep quality (Oliveira Carvalho et al., 2021).”
Zila-Velasque, J. P., Grados‐Espinoza, P., Coba-Villan, N., Quispe, J., Taipe-Guilln, Y. F., Pacheco, E., Ccasa-Valero, L., Failoc‐Rojas, V. E., Díaz-Vélez, C., & Valladares-Garrido, M. J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010519 · Cited by 10
Fatigue in Post-Acute Sequelae of Coronavirus Disease 2019
Abbott, Z., Summers, W., & Niehaus, W. (2023) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2023.04.006 · Cited by 9
Jin, H., Gonzalez, J. S., Pyatak, E. A., Schneider, S., Hoogendoorn, C. J., Hernandez, R., Lee, P.-J., & Spruijt‐Metz, D. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111442 · Cited by 9
Baird, M., Dubowitz, T., Cantor, J. H., & Troxel, W. (2022) · Sleep · doi:10.1093/sleep/zsab303 · Cited by 11
“Increased risk and incidence of these events may also negatively impact sleep quality.(18,40)”
BackgroundInfluentialSleep Quality Among Informal Caregivers During the COVID-19 Pandemic: A Cross-Sectional Study
Greaney, M. L., Kunicki, Z. J., Drohan, M. M., Nash, C. C., & Cohen, S. A. (2022) · Gerontology and Geriatric Medicine · doi:10.1177/23337214211057387 · Cited by 11
“Some research indicates it is associated with increased sleep problems (Jahrami et al., 2021) and reduced sleep quality (Casagrande et al.”
BackgroundSaals, B. A. D. F., Boss, H. M., & Pot, G. K. (2022) · Chronobiology International · doi:10.1080/07420528.2022.2054347 · Cited by 14
“(Jahrami et al. 2021).”
Fabbri, M., Simione, L., Martoni, M., & Mirolli, M. (2022) · Clocks & Sleep · doi:10.3390/clockssleep4010016 · Cited by 9
“Interestingly, it has been reported that the spread of the coronavirus disease in 2019 (known as COVID-19) showed wide-ranging disruptions to personal schedules, psychological health, and sleep, throughout the world [3,4].”
BackgroundShiovitz‐Ezra, S., & Erlich, B. (2022) · Educational Gerontology · doi:10.1080/03601277.2022.2067960 · Cited by 9
“A metaanalysis and systematic review (Jahrami et al., 2021) of sleep problems during the pandemic that included 44 studies of 54,231 participants from 13 countries, found a global pooled sleep problem prevalence rate of 35.7%.”
BackgroundInfluentialPaczkowska, A., Nowakowska, E., Michalska, J., Ficner, H., Tyrchniewicz, J., Szymański, A., Wańkowicz, K., Namyślak, K., Gala, A., Michalak, S. S., et al. (2022) · Psychology Health & Medicine · doi:10.1080/13548506.2022.2061719 · Cited by 9
“Moreover, patients with COVID-19 appeared to be the most affected group, with a pooled rate of 74.8% (Jahrami et al., 2021; Lin et al., 2021).”
BackgroundInfluentialKalantar‐Hormozi, B., Khosravi, Z., & Sabzi, N. (2022) · Brain and Behavior · doi:10.1002/brb3.2688 · Cited by 11
Zou, Q., Tang, Y., Jiang, C., Lin, P., Tian, J., & Sun, S. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1024668 · Cited by 10
“, anxiety and depression), which suggests that sleep specialists treating this suggests that sleep specialists should consider psychiatric co-morbidities when treating sleep problems, and vice versa (Jahrami et al., 2021).”
BackgroundChoi, J., Kim, M., Lee, S. W., Rhee, S. Y., Yang, H., Kim, H. J., Kwon, R., Koyanagi, A., Smith, L., Kim, M. S., et al. (2023) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2023.103695 · Cited by 9
Ye, Y., Wang, H., Ye, L., & Gao, H. (2024) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2024.049606 · Cited by 10
“However, research indicates that sleep problems were widespread during the COVID-19 pandemic [6,7], affecting about 40% of the general population and healthcare workers, with an even higher incidence rate among COVID-19 patients [8].”
Tracking Happiness in Times of COVID-19: A Bibliometric Exploration
Jigani, A.-I., Delcea, C., Florescu, M., & Cotfas, L. (2024) · Sustainability · doi:10.3390/su16124918 · Cited by 8
“Subsequent investigations have revealed that such restrictions have been associated with adverse psychological effects, including anxiety and depression [28–32], sleep disturbances [33–37], and alterations in physical activity levels [36,38,39].”
BackgroundLifetime prevalence and characteristics of sleep paralysis in Italian university students population
Colombo, C., & Cellini, N. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.08.013 · Cited by 8
Sweetman, A., McEvoy, R. D., Frommer, M. S., Adams, R., Chai‐Coetzer, C. L., Newell, S., Moxham-Hall, V. L., & Redman, S. (2024) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11374 · Cited by 8
“52 In this environment, stakeholders were willing to prioritize the management of insomnia, and participate in the Stakeholder Advisory Committee.”
Gold, D., Sharman, A., & Thomas, D. (2022) · Humanities and Social Sciences Communications · doi:10.1057/s41599-022-01079-7 · Cited by 11
“Here are a few examples from the literature: ● Stress: Lakhan et al. (2020); Pandey et al. (2020); Serafini et al. (2020); Han et al. (2020) ● Violence: Devi (2020); Han et al. (2020) ● Addictions: Jemberie et al. (2020); Han et al. (2020); Kirzinger et al. (2020) ● Lack of exercise: Kaur et al. (2020) ● Inadequate nu…”
InfluentialHaimov, I., Szepsenwol, O., & Cohen, A. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s378271 · Cited by 8
Grøtte, T., Hagen, K., Eid, J., Kvale, G., Hellard, S. L., & Solem, S. (2022) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2022.100758 · Cited by 9
Jääskeläinen, T., Härkänen, T., Haario, P., Isosaari, E., & Lundqvist, A. (2022) · BMC Public Health · doi:10.1186/s12889-022-14574-y · Cited by 8
Hokett, E., Arunmozhi, A., Campbell, J., & Duarte, A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.949364 · Cited by 8
“Sleep problems during COVID-19 have been reviewed (Alimoradi et al., 2021; Jahrami et al., 2021).”
Background
Metadata
- Authors
- Jahrami, H., BaHammam, A. S., Bragazzi, N. L., Saif, Z., Faris, M., & Vitiello, M. V.
- Affiliations
- Ministry of Health (BH)
- King Saud University (SA)
- York University (CA)
- University of Sharjah (AE)
- University of Washington (US)
- ORCID
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2021-02
- Volume
- 17
- Issue
- 2
- Pages
- 299-313
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- PMC
- PMC7853219
- OpenAlex
- W3097605919
- Cited by
- 751
- References
- 68
- Citations by year
- 2026: 32 · 2025: 57 · 2024: 90 · 2023: 180 · 2022: 268 · 2021: 124
- FWCI
- 11.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- sleep disorders, COVID-19 pandemic, healthcare workers, COVID-19 patients, general population
- MeSH terms
- COVID-19, SARS-CoV-2, Humans, Quarantine, Sleep Wake Disorders, Pandemics
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