Systematic Review of Prevalence of Sleep Problems in India: A Wake- up Call for Promotion of Sleep Health

Abstract

An ever-increasing burden of non-communicable diseases, especially in the post pandemic times and an association of sleep problems with them highlighted a felt need to estimate the sleep problem in India. A meta-analysis of the studies conducted on Indian data was planned adhering to PRISMA guidelines. An electronic search of available literature was performed on databases including PubMed, Google Scholar, PsycNet, and Epistemonikos. 100 eligible articles were analysed. To assess the methodological quality 10-points Joanna Briggs Institute (JBI) checklist for prevalence studies was used. The pooled estimates for prevalence of Insomnia found were 25.7%, OSA 37.4%, and RLS 10.6%. An increased prevalence was seen in patients of diabetes, heart disease patients and in otherwise healthy population. Subgroup analysis showed a higher prevalence in patient population and in the otherwise healthy population too,; e.g. Insomnia 32.3% (95% CI: 18.6% to 49.9%, I2=99.4%) and 15.1% (95% CI: 8.0% to 26.6%, I2=99.1%); OSA 48.1% (95% CI: 36.1% to 60.3%, I2=97.4%) and 14.6% (95% CI: 9.2% to 22.5%, I2=97.4%) and RLS 13.1% (95% CI: 8.7% to 19.3%, I2=91.9%) and 6.6% (95% CI: 2.4% to 16.4%, I2=99.1%) respectively. Excessive daytime sleepiness remained prevalent (19.6%) (95 % CI: 8.4% to 39.1%, I2=99.8%) in the healthy, which was alarming. A multipronged approach for sleep management, evaluation and research is the need of the hour for managing non communicable disorders and for promoting sleep health in the healthy population.