Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies

Zeng, Liang-Nan; Zong, Qian-Qian; Yang, Yuan; Zhang, Ling; Xiang, Yifan; Ng, Chee H.; Chen, Ligang; Xiang, Yu‐Tao

doi:10.3389/fpsyt.2020.577429

Cited by 132 publications

(79 citation statements)

References 49 publications

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“…Previous studies indicated that females were a high-risk population for insomnia [ 59 ]. A meta-analysis revealed the prevalence of insomnia in females was higher than that in males [ 60 ]; also, females were the predicted risk factor of insomnia during the COVID-19 pandemic [ 61 , 62 ]. Our results supported previous studies.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial

Liu¹,

Qiao²,

Xu³

et al. 2021

J Med Internet Res

103

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Background The prevalence of depressive and anxiety symptoms in patients with COVID-19 is higher than usual. Previous studies have shown that there are drug-to-drug interactions between antiretroviral drugs and antidepressants. Therefore, an effective and safe treatment method was needed. Cognitive behavioral therapy (CBT) is the first-line psychological therapy in clinical treatment. Computerized CBT (cCBT) was proven to be an effective alternative to CBT and does not require face-to-face therapy between a therapist and the patient, which suited the COVID-19 pandemic response. Objective This study aims to evaluate the efficacy of the cCBT program we developed in improving depressive and anxiety symptoms among patients with COVID-19. Methods We customized a cCBT program focused on improving depressive and anxiety symptoms among patients with COVID-19, and then, we assessed its effectiveness. Screening was based on symptoms of depression or anxiety for patients who scored ≥7 on the Hamilton Depression Rating Scale (HAMD17) or the Hamilton Anxiety Scale (HAMA). A total of 252 patients with COVID-19 at five sites were randomized into two groups: cCBT + treatment as usual (TAU; n=126) and TAU without cCBT (n=126). The cCBT + TAU group received the cCBT intervention program for 1 week. The primary efficacy measures were the HAMD17 and HAMA scores. The secondary outcome measures were the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Athens Insomnia Scale (AIS). Assessments were carried out pre- and postintervention. The patients’ symptoms of anxiety and depression in one of the centers were assessed again within 1 month after the postintervention assessment. Results The cCBT + TAU group displayed a significantly decreased score on the HAMD17, HAMA, SDS, SAS, and AIS after the intervention compared to the TAU group (all P<.001). A mixed-effects repeated measures model revealed significant improvement in symptoms of depression (HAMD17 and SDS scores, both P<.001), anxiety (HAMA and SAS scores, both P<.001), and insomnia (AIS score, P=.002) during the postintervention and follow-up periods in the cCBT + TAU group. Additionally, the improvement of insomnia among females (P=.14) and those with middle school education (P=.48) in the cCBT + TAU group showed no significant differences when compared to the TAU group. Conclusions The findings of this study suggest that the cCBT program we developed was an effective nonpharmacological treatment for symptoms of anxiety, depression, and insomnia among patients with COVID-19. Further research is warranted to investigate the long-term effects of cCBT for symptoms of anxiety, depression, and insomnia in patients with COVID-19. Trial Registration Chinese Clinical Trial Registry ChiCTR2000030084; http://www.chictr.org.cn/showprojen.aspx?proj=49952

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial

Liu¹,

Qiao²,

Xu³

et al. 2021

J Med Internet Res

103

View full text Add to dashboard Cite

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“…Female gender is a strong risk factor for insomnia. According to a meta-analysis of observational studies about the sex differences in insomnia by Zeng et al [ 20 ], females had a significantly higher prevalence of insomnia than males in the general population, with a pooled odds ratio of 1.6. The relationship between female gender and insomnia could be explained by the literature evidence, which shows that females are more likely to be exposed to socioeconomic determinants of insomnia, such as lower educational level and unemployment, physiological (hormonal) factors, and psychological risk factors such as anxiety and stressful life events [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Depression and Insomnia in Community-Dwelling Elderly People: A Cross-Sectional Evidence of Their Bidirectional Relationship

Tsaras¹,

Tsiantoula²,

Papathanasiou³

et al. 2021

Cureus

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The aim of this study was to examine associated factors of depression and insomnia in community-dwelling elderly people in order to identify independent predictors. Materials and methods A cross-sectional study was conducted among 250 older people aged 60 years and over living in an urban area. A stratified random sampling method was used for recruiting samples from five Open Care Centers for Elderly People of the Municipality of Larissa, Greece. Data were obtained through a questionnaire that included demographic, socioeconomic, and health-related characteristics, 15-item Geriatric Depression Scale (GDS-15), and Athens Insomnia Scale (AIS). Simple and multiple logistic regression analysis was performed. Results The prevalence of depression and insomnia was 28.4% (95% CI: 22.9-33.9) and 39.2% (95% CI: 33.0-45.4), respectively. Our findings showed that the overall GDS-15 score was positively related to the overall AIS score (r = 0.405; p < 0.001). The best-fit regression analysis demonstrated four significant predictors (marital status, monthly income, body weight status, and insomnia) explaining 31.6% of the variance in depression risk. Moreover, community-dwelling elderly Greek people with insomnia symptoms were females, had a lower monthly income, and more likely to suffer from chronic diseases and depression. Conclusion These findings point to the importance of recognizing risk factors for both depression and insomnia in attempting to apply preventive interventions in the elderly and optimize their quality of life.

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“…A meta-analysis of the prevalence of insomnia in the general population estimated it to be 22.0% (Zeng et al, 2020). The actual prevalence in older adults is hard to estimate, as there are few population-based studies that have diagnosed insomnia in samples of older adults.…”

Section: Insomniamentioning

confidence: 99%

Sleep in Older Adults and Its Possible Relations With COVID-19

Pires

Ishikura

Xavier

et al. 2021

Front. Aging Neurosci.

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Since the beginning of the COVID-19 pandemic, older adults have been found to be a highly vulnerable group, with a higher prevalence of severe cases and negative outcomes. Research has focused on the reasons why older adults are at greater risk; Sleep-related factors have been suggested as one possible explanation for this. An individual’s sleep pattern undergoes significant changes over the course of their life. In older adults a specific sleep profile can be observed, one characterized by advanced sleep timing, a morningness preference, longer sleep-onset latency, shorter overall sleep duration, increased sleep fragmentation, reduced slow-wave sleep and, increased wake time after sleep onset. Additionally, an increased prevalence of sleep disorders can be observed, such as obstructive sleep apnea and insomnia. Previous research has already linked sleep disorders (especially sleep apnea) with COVID-19, but few studies have focused specifically on the older population. We believe that the intrinsic sleep patterns of older adults, and the prevalence of sleep disorders in this population, may be important factors that could explain why they are at a greater risk of negative COVID-19 outcomes. In this review, we discuss the relationship between sleep and COVID-19 among older adults, focusing on three different aspects: (1) Sleep-related issues that might increase the likelihood of getting infected by SARS-COV-2; (2) Sleep disturbances that might increase the predisposition to worse COVID-19 prognosis and outcomes; and (3) COVID-19-related aspects affecting community-dwelling older adults, such as social isolation, quarantine, and home confinement, among others, that might impact sleep.

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Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies

Cited by 132 publications

References 49 publications

The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial

The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial

Predictors of Depression and Insomnia in Community-Dwelling Elderly People: A Cross-Sectional Evidence of Their Bidirectional Relationship

Sleep in Older Adults and Its Possible Relations With COVID-19

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