1. In this systematic review and meta-analysis, women exhibited a greater prevalence of sleep problems across genders during the COVID-19 pandemic.
2. In a subgroup analysis, there was a lower rate of sleep problems in regions where lockdown was implemented, compared to regions where only control measures without lockdown were in place.
Evidence Rating Level: 1 (Excellent)
Current literature suggests COVID-19 has introduced and possibly exacerbated sleep problems. However, no empirical studies have been performed comparing sleep problems across genders during the COVID-19 pandemic, which is important to elucidate when considering treatment options. This study aimed to shed light on the prevalence of sleep problems across genders during the COVID-19 pandemic.
This systematic review and meta-analysis included 99 papers (54 papers in female subgroup and 45 papers in male subgroup) after screening and full text-review for eligibility criteria. Studies with primary outcomes assessing for sleep problems (defined as insomnia symptoms and poor sleep quality) during the COVID-19 pandemic (December 2019 to February 2021) were included. No limitations were imposed regarding participant characteristics. Primary outcome assessed for prevalence of gender-specific sleep problems (assessed using varied survey instruments) during the COVID-19 pandemic.
Results found that females had a higher pooled estimated prevalence of sleep problems (41%) in comparison to men (31%). In subgroup analysis, the prevalence of sleep problems was higher amongst patients infected with COVID-19 compared to other subgroups. Furthermore, the prevalence of sleep problems was lower in regions where lockdown was implemented in comparison to regions where other control measures were in place, and such regardless of gender. This study was limited due to the subjective measure of sleep problems, which was self-reported. Furthermore, papers using varied sleep problem survey instruments were included in this study, which made it difficult to capture the heterogenous nature of sleep problems. Nonetheless, these findings suggest that COVID-19 related events and restrictions have impacted sleep, which imposed a greater effect on women in cross-gender analysis and should be a target for future treatment.
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