Cited by 751COVID-19 and Mental HealthSleep and related disordersObstructive Sleep Apnea Research

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

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Jahrami, Haitham, BaHammam, Ahmed S., Bragazzi, Nicola Luigi, Saif, Zahra, Faris, MoezAlIslam, Vitiello, Michael V.·2021·Journal of Clinical Sleep Medicine

DOI 10.5664/jcsm.8930PMC PMC7853219

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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.

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“Along with high rates of anxiety and depression (4, 5), there was an increase in sleep problems during the pandemic, with an estimated prevalence of 38% in the general population (5, 6).”
Background
Sleep and Its Disorders: When ToM Is Not Awake
Montes-Latorre, E., & Porcacchia, P. (2023) · Logic, argumentation & reasoning · doi:10.1007/978-3-031-46742-4_10
Taking Medicine in the Right Way
Mohiuddin, A. K. (2022) · Global Journal of Pharmacy & Pharmaceutical Sciences · doi:10.19080/gjpps.2022.10.555790
Estudio longitudinal del efecto del confinamiento por COVID-19 en la aparición de trastornos del sueño en una muestra clínica de niños y adolescentes españoles
Martínez, V. A. (2023) · Revista de Psicología Clínica con Niños y Adolescentes · doi:10.21134/rpcna.2023.10.3.3
“En Jahrami et al. (2021) se realiza un metaanálisis en el que encontraron resultados similares.”
Background
Evidence to support health system prioritization of health behaviors in the COVID-19 era
JaKa, M. M., Ziegenfuss, J. Y., Dinh, J. M., Jacobson, L. J., Kottke, T. E., Knudson, S. M., Heim, C. C., Gallagher, J. M., Campbell, K. D., Rivard, R. L., et al. (2024) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2024.02.004
High Prevalence of Insomnia in Breast Cancer Patients: Exploring Feasibility and Potential Benefits of a Digital Sleep Diary – A Two-Stage Observational Study (Preprint)Preprint
Pilecka, I., Richardson, L., Noori, N., Taylor, M., Berger, L., Godec, T. R., Goldsmith, P., Siddle, J., Brammer, Z., Galasso, E., et al. (2024) · doi:10.2196/preprints.57220
Implications of COVID-19 on Emergency Physicians in Trinidad: Considerations for the Future
Huggins, C., & Modeste-James, A. (2024) · Springer eBooks · doi:10.1007/978-3-031-55293-9_9
Psychosocial Predictors of Sleep Disturbances during COVID-19: differential contributions of demographic, psychological, pandemic-related factors to sleep health.Preprint
Varela, V., Giogkaraki, E., Vlastos, D., Alzueta, E., Perrin, P. B., Ramos‐Usuga, D., Arango‐Lasprilla, J. C., & Liozidou, A. (2024) · Research Square · doi:10.21203/rs.3.rs-4265194/v1
Addictive behaviors among youth and adolescents in the digital age
(2024) · Frontiers research topics · doi:10.3389/978-2-8325-4853-0 · Cited by 1
Observation of the Therapeutic Effect of Ultrasound-Guided Stellate Ganglion Block on Sleep Disorders in Patients Recovered from COVID-19
Chen, P., Hu, Y., & Zhang, N. (2024) · OALib · doi:10.4236/oalib.1111525
Perception of negative emotions and sleeping difficulties among adults in Poland during the COVID-19 pandemic
Wypych-Ślusarska, A., & Głogowska-Gruszka, A. (2024) · Journal of Health Inequalities · doi:10.5114/jhi.2024.136345
Effects of Psychological Intervention Based on the Self-Transcendence Theory on the Sleep Quality of Chinese Nurses
Guofang, W., Zhang, W., & Zhu, Z. (2024) · Iranian Journal of Public Health · doi:10.18502/ijph.v53i4.15558
The Relationship between Nurses’ COVID-19 Risk Perceptions, Anxiety Levels and Sleep Quality
Erbi̇l, N., Aksoy, F., Yıldız, G., & Yanık, H. G. B. (2024) · Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi · doi:10.38108/ouhcd.1337076
The COVID-19 pandemic, mental health, and sleep: Linking depression, anxiety, and perceived stress
Bücker, J., Rosa, A. R., & Czepielewski, L. S. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-95650-5.00011-2
Sleep Eeg Automatic Sleep Staging Model Based on Residual and Multi-Level Attention NetworkPreprint
Zhang, K., Zhao, D., Shen, Y., Liu, J., Lu, Q., & Chen, Y. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4877931
Adherence to Medication and Treatment Guidelines: Most Important but Mostly Avoided
Mohiuddin, A. K. (2023) · Women Health Care and Issues · doi:10.31579/2642-9756/136
The Effect of Fear of Covid-19 on Anxiety and Postpartum Depression in Postpartum Women: Cross-sectional studyPreprint
KIZOGLU, C. N., & Bektaş, H. A. (2024) · Research Square · doi:10.21203/rs.3.rs-4693602/v1
Psychological Impact of Covid-19 on General Population in China: A Comparison between Delta Variant And Omicron VariantPreprint
Lü, Y., Hu, Y., Zhao, W., Zhou, Y., Gao, Y.-Z., Ding, X., Xu, Z., & Li, Y. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4942579
Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study
Meredith, S. J., Shepherd, A. I., SAYNOR, Z. L., Scott, A., Gorczynski, P. F., Perissiou, M., Horne, M., McNarry, M. A., Mackintosh, K. A., & Witcher, C. S. G. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2397086
“It is difficult to reach a firm conclusion as to why this was the case, but one possible explanation relates to lifestyle changes and disrupted sleep during the COVID-19 pandemic – including decreased sleep quality [83–86].”
Health behaviors at the start of the COVID-19 pandemic: Evidence for indirect effects of subjective social status via psychological distress
Rodriguez-Stanley, J., Bogg, T., Jiang, Y., & Zilioli, S. (2024) · Journal of Health Psychology · doi:10.1177/13591053241284075
“For instance, Beck et al. (2021) reported sleep issues in 74% of their French sample, while a meta-analysis of 13 countries found that approximately 35% of study participants experienced sleep problems (Jahrami et al., 2021).”
Quarantine Experience-Based Differences in Factors Associated with Depression Among Koreans During the COVID-19 Pandemic
Jeong, Y., & Park, M. (2024) · Healthcare · doi:10.3390/healthcare12212165
“One meta-analysis during the COVID-19 pandemic found that 35.7% of all participants and 32.3% of the general population experienced sleep problems [51].”
Influential
MEDICAMENTALIZAÇÃO NA PANDEMIA DE COVID-19: Consumo de psicofármacos em duas farmácias no sul fluminense
Afonso, J. G. M., & dos Santos, J. R. B. (2024) · Psicologia e Saúde em Debate · doi:10.22289/2446-922x.v10a2a38 · Cited by 1
Cognitive risk and behaviour related to the effects of mobile phone use on sleep quality: an analysis of data from Chinese college students
He, Y., Fan, L., Xu, Y., Li, J., Song, J., Gao, Q., Cai, C., Jia, M., Liang, J., Huang, J., et al. (2024) · Psychology Health & Medicine · doi:10.1080/13548506.2024.2444433
Sleep Disorders, Inflammation, and COVID-19
García‐García, F., Krueger, J. M., López-Muciño, L. A., Bravo-González, F., Leyva-Grado, V. H., & Jiménez‐Correa, U. (2024) · Integrated science · doi:10.1007/978-3-031-72079-6_16
Biological rhythms and psychiatric symptoms in COVID-19 individuals: a cross-sectional multicentric study
Mattia-Maximiano, B. C., Mioranza-Koppe, M., Silva, R. H., Arent, C., Amboni, G., Pedro, L. C., Bertollo, A. G., Cortez, A. D., de Medeiros, J., Moreira, F. P., et al. (2025) · Biological rhythm research · doi:10.1080/09291016.2024.2449337
“Jahrami et al. (2021) reported that the rate of sleep problems was twice as high in individuals with COVID-19 than in the general population.”
Psychological and Behavioural Aspects of the COVID-19 Pandemic
Kourtidis, P., Sternberg, H., Steinert, J., Büthe, T., Veltri, G., Fasolo, B., & Galizzi, M. M. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009438438.012
Evidence from Experiments and Behavioural Insights
Galizzi, M. M. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009438438.003
Associations of substance use and positive coping behaviors with sleep quality during the COVID-19 pandemic
Laudie, J., Stangl, B. L., Gunawan, T., Schwandt, M. L., Cheng, C., Gilmore, A. K., Goldman, D. A., Ramchandani, V. A., Diazgranados, N., & Luk, J. W. (2025) · Frontiers in Sleep · doi:10.3389/frsle.2024.1504489 · Cited by 1
Sleep Alterations in the Population of the Metropolitan Area of Mexico and Their Association with Lifestyle Changes During COVID-19 Confinement
Ayala-Moreno, M. D. R., Martínez-Serrano, P. A., Melgarejo-Gutiérrez, M. A., Mondragón, A. R. H., Martínez-Basila, A., Martínez-Coronado, A., Losana-Valencia, M. J., Vargas-Medina, E., Colin-Ramírez, E., & Benítez-Rico, A. (2025) · Clocks & Sleep · doi:10.3390/clockssleep7010006
“%) in sleep impairment [9], emphasizing a decrease in sleep quality and an increase in insomnia [8].”
Physical Fitness and Mental Health Three Months after COVID-19 Infection in Young and Elderly Women
Wang, M., Lei, O.-K., Wong, F. U. K., Wong, W. S. P., Hui, W. H. C., Leong, G. C. H., Fang, W., & Kong, Z. (2025) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2025.060875
“Previous data have shown that the prevalence of sleep problems in the general population reached approximately 40% during the COVID-19 pandemic, significantly higher than the 15% rate reported in a meta-analysis [56].”
CLINICAL FEATURES OF SLEEP DISORDERS IN SOMATOFORM DISORDERS
Макарова, И. И., & Огоренко, В. (2024) · Ukrains kyi Visnyk Psykhonevrolohii · doi:10.36927/2079-0325-v32-is4-2024-5
The impact of the COVID-19 Epidemic on Mental Health among University Staff and Students: An Institution-Based Cross-Sectional Study
Latt, S. S., Rai, S. B., Leela, L., Sudarsan, S., & Ravichandran, M. (2025) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2025.00177
Training intensity, sleep, and athletes’ well-being during COVID-19 lockdowns
Mor, G., & Gafter, L. (2025) · Scientific Journal of Sport and Performance · doi:10.55860/issf4908
The Effect of COVID–19 Outbreak and Vaccination on Sleep Quality, Sleep Chronotype (Morningness–Eveningness), Depression, Anxiety and Stress; A Cross-sectional Study Among Isfahani Residents
Amra, B., Soltaninejad, F., Ghaderi, F., Masnavi, E., & Hassanzadeh, S. (2025) · THE NEW ARMENIAN MEDICAL JOURNAL · doi:10.56936/18290825-2.v19.2025-61
Understanding the relationship of sleep-related problems with positive affect and negative affect in young people: Insights from the EHDLA study
Unda‐López, A., Quiroz-Cárdenas, F., López, P. J. T., Sepulveda, R. A. Y., Gutiérrez‐Espinoza, H., Arancibia, J. E. O., Rahmati, M., Smith, L., Stubbs, B., & López‐Gil, J. F. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106659

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: Jahrami, Haitham
BaHammam, Ahmed S.
Bragazzi, Nicola Luigi
Saif, Zahra
Faris, MoezAlIslam
Vitiello, Michael V.
Venue: Journal of Clinical Sleep Medicine
Publisher: Springer Science and Business Media LLC
Published: 2021-02
Volume: 17
Issue: 2
Pages: 299-313
ISSN: 1550-9389 (ISSN-L)
1550-9397
DOI: 10.5664/jcsm.8930
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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Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis

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