Global prevalence of insomnia symptoms in undergraduate university students: a systematic review and meta-analysis

Insomnia is increasingly recognized as a public health concern; however, undergraduate university students remain relatively understudied. This study aimed to estimate the overall pooled prevalence of insomnia symptoms in this population to inform the need for targeted care. For this systematic review and meta-analysis, we searched five databases to identify papers published between January 1, 1993, and January 17, 2025, which investigated the prevalence or proportion of insomnia in undergraduate university students using validated measures. Studies with biased samples were excluded. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Data were synthesized using random-effects meta-analysis and meta-regression. Subgroup analyses were conducted based on continent, screening instrument, field of study, and sampling method. The review was registered on PROSPERO (CRD42025617914). The search yielded 2379 non-duplicate citations, of which 48 met the inclusion criteria, contributing 55 prevalence estimates based on data from 95 938 students. The pooled prevalence of insomnia in undergraduate university students was 46.9% (95% CI = 40.1% to 53.6%). Heterogeneity was high (I ² = 99.8%). Meta-regression indicated that rates varied by continent and screening instrument. Findings suggest that nearly half of undergraduate students experience insomnia symptoms, highlighting the need for university-level responses that combine universal sleep health promotion with targeted interventions. Further methodologically rigorous and culturally sensitive research is required to guide policy and practice.