Article type
Abstract
Background: As our understanding of COVID-19 evolves, it's evident that besides acute infection, it induces diverse symptoms and sequelae known as long COVID. Yet, the link between COVID-19 and sleep disorders remains uncertain. Our aim was to systematically review this association and assess risk certainty through meta-analysis."
Methods: We conducted a systematic search of relevant studies in the following databases from December 2019 to November 2022: Embase, PubMed, and Web of Science. Two reviewers independently reviewed the included articles and assessed the risk of bias. Cohort study were included for meta-analysis, if they reported adjusted relative risks with 95% confidence covid-19 between the risk of sleep disorder. Random effects meta-analyses were performed to combine the results of the included studies. we assessed the certainty of the risks using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Relevant subgroup and meta-regression analyses were pre-planned to investigate potential influencing factors, with the presentation of evidence reported as relative risk.
Results: A total of 12 retrospective cohort studies involving more than 13.037 million eligible participants were included this systematic review. Low-certainty evidence suggested that those who infected with COVID-19 are associated with 56% higher risk of sleep disorders than that of patients without COVID-19 (RR=1.56, 95%CI: 1.41 to 1.7, absolute risk difference=6 more per 1000 persons), which include 45% risk of insomnia (RR=1.45, 95%CI: 1.34 to 1.61, absolute risk difference=2.53) and 49% risk of sleep apnea (RR=1.49, 95%CI: 1.17 to 1.81, absolute risk difference=4.45). Subgroup analyses showed that the differences between different type of insomnia and sleep disorder were not distinct.
Conclusion: This systematic review and meta-analysis support the association between COVID-19 infection and sleep disorder including insomnia and sleep apnea. Although a significant association was observed, the effect size is relatively small, and the overall certainty of evidence is low or very low. Post-COVID-19, it is imperative to prepare for and prevent adverse symptoms. However, due to limited evidence, this article's findings may be constrained.
Methods: We conducted a systematic search of relevant studies in the following databases from December 2019 to November 2022: Embase, PubMed, and Web of Science. Two reviewers independently reviewed the included articles and assessed the risk of bias. Cohort study were included for meta-analysis, if they reported adjusted relative risks with 95% confidence covid-19 between the risk of sleep disorder. Random effects meta-analyses were performed to combine the results of the included studies. we assessed the certainty of the risks using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Relevant subgroup and meta-regression analyses were pre-planned to investigate potential influencing factors, with the presentation of evidence reported as relative risk.
Results: A total of 12 retrospective cohort studies involving more than 13.037 million eligible participants were included this systematic review. Low-certainty evidence suggested that those who infected with COVID-19 are associated with 56% higher risk of sleep disorders than that of patients without COVID-19 (RR=1.56, 95%CI: 1.41 to 1.7, absolute risk difference=6 more per 1000 persons), which include 45% risk of insomnia (RR=1.45, 95%CI: 1.34 to 1.61, absolute risk difference=2.53) and 49% risk of sleep apnea (RR=1.49, 95%CI: 1.17 to 1.81, absolute risk difference=4.45). Subgroup analyses showed that the differences between different type of insomnia and sleep disorder were not distinct.
Conclusion: This systematic review and meta-analysis support the association between COVID-19 infection and sleep disorder including insomnia and sleep apnea. Although a significant association was observed, the effect size is relatively small, and the overall certainty of evidence is low or very low. Post-COVID-19, it is imperative to prepare for and prevent adverse symptoms. However, due to limited evidence, this article's findings may be constrained.