Wake-up Call for India on Sleep Health: Systematic Review Findings

An Increased burden of noncommunicable diseases and their association with sleep problems exists.

The objective of this study was to estimate the prevalence of sleep problems in India.

A meta-analysis of the studies conducted on Indian data was planned using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. To assess the methodological quality, a 10-point Joanna Briggs Institute (JBI) checklist for prevalence studies was used.

Pooled estimates of 100 eligible studies showed the prevalence was 25.7% for insomnia (95% confidence interval [CI]: 16.3%-38.0%, I2 = 99.4%), for obstructive sleep apnea (OSA), 37.4% (95% CI: 27.8%-48.2%, I2 = 98.3%), and for restless leg syndrome (RLS) was10.6% (95% CI: 7% to 15.9%, I2 = 97.3%). An increased prevalence was seen in patients with diabetes, heart disease, and other conditions. JBI checklist scores ranged from 4 to 9, with a median score of 7. Subgroup analysis showed that both patients and the general population had sleep disorders; prevalence of insomnia 32.3% (95% CI: 18.6%-49.9%, I2 = 99.4%) and 15.1% (95% CI: 8.0%-26.6%, I2 = 99.1%), OSA 48.1% (95% CI: 36.1%-60.3%, I2 = 97.4%) and 14.6% (95% CI: 9.2-22.5%, I2 = 97.4%), and RLS 13.1% (95% CI: 8.7%-19.3%, I2 = 91.9%) and 6.6% (95% CI: 2.4%-16.4%, I2 = 99.1%) in patients and general population, respectively. Excessive daytime sleepiness was a common symptom. Different methodologies and diverse population groups were studied, thus increased heterogeneity was seen.

Increased prevalence of sleep problems existed in noncommunicable diseases and the general population. A need to recognize the allostatic load of sleep problems in noncommunicable diseases is highlighted.