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      The prevalence and severity of insomnia symptoms during COVID-19: A global systematic review and individual participant data meta-analysis

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          Abstract

          Introduction

          There have been no previous meta-analytic studies that have looked at the prevalence of insomnia symptoms in different COVID-19 groups using a single assessment instrument to evaluate insomnia symptoms while maintaining data homogeneity. The current review's associated goal is to undertake an individual participant data (IPD) analysis to further investigate past meta-analyses, a method that has been shown to be more robust than standard meta-analyses.

          Meethods

          Only studies that used the Insomnia Severity Index (ISI) to assess insomnia are used in this analysis. The IPDMA was performed and registered in PROSPERO in compliance with the PRISMA IPD Statement (CRD42021275817). From November 2019 to August 2021, researchers explored seventeen databases and six preprint services for relevant studies.

          Results

          The pooled estimate of insomnia symptoms (subthreshold and clinically significant) was 52.57%. An estimated 16.66% of the population suffered from clinically significant insomnia, of which 13.75% suffered from moderate insomnia, and 2.50% suffered from severe insomnia. The different populations' grouping had no statistically significant differences in the prevalence of insomnia symptoms. Insomnia symptoms did not appear to be associated with age or sex.

          Conclusion

          Our findings imply that the COVID-19 pandemic is linked to a significant rise in subthreshold insomnia symptoms, but not to moderate or severe insomnia. Educating people from all walks of life about the importance of sleep and the risk of acquiring insomnia symptoms during this or future pandemics should be a top concern.

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          Most cited references104

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          Measuring inconsistency in meta-analyses.

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            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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              Quantifying heterogeneity in a meta-analysis.

              The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity. Copyright 2002 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                Sleep Med
                Sleep Med
                Sleep Medicine
                Published by Elsevier B.V.
                1389-9457
                1878-5506
                8 August 2022
                8 August 2022
                Affiliations
                [a ]Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
                [b ]Princess Noura bint Abdul Rahman University, Riyadh, Saudi Arabia
                [c ]The Tunisian Center of Early Intervention in Psychosis, Psychiatry Department “Ibn Omrane”, Tunisia
                [d ]Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
                [e ]Ministry of Health, Manama, Bahrain
                [f ]Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
                [g ]Federal University of São Paulo, Brazil
                [h ]Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, 361000, China
                [i ]Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China
                [j ]Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Canada
                [k ]Somnogen Canada Inc., College Street, Toronto, Canada
                [l ]Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
                [m ]Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, 11324, Saudi Arabia
                [n ]The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
                [o ]Psychiatry & Behavioral Sciences, Gerontology & Geriatric Medicine, and Biobehavioral Nursing, University of Washington, Seattle, WA, 98 l 95-6560, USA
                Author notes
                []Corresponding author. Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
                Article
                S1389-9457(22)01066-8
                10.1016/j.sleep.2022.06.020
                9359588
                36030616
                8c3742bf-c12d-460a-9203-c5c9aabb6fad
                © 2022 Published by Elsevier B.V.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 23 May 2022
                : 20 June 2022
                : 24 June 2022
                Categories
                Article

                Medicine
                kewords: sleep disorder,sleep disturbance,pandemic,insomnia,sleep hygiene,circadian rhythm
                Medicine
                kewords: sleep disorder, sleep disturbance, pandemic, insomnia, sleep hygiene, circadian rhythm

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