Worldwide Prevalence of Poor Sleep Quality in Adolescents Aged 10-19 Years: A Systematic Review and Meta-Analysis

Studies show significant variability in adolescent sleep quality prevalence, likely due to differing definitions of adolescence and the use of various assessment questionnaires. This meta-analysis aimed to determine the prevalence of poor sleep quality using the Pittsburgh Sleep Quality Index (PSQI) among adolescents aged 10 to 19 years.

PubMed, Scopus, and Web of Science databases were comprehensively searched until October 2, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tool. The random effects model was employed to compute the pooled prevalence with a 95% confidence interval. Furthermore, subgroup analyses were conducted to explore the sources of heterogeneity.

This study analyzed 28 cross-sectional studies involving 191,408 adolescents aged 10-19 , with a male proportion of 46.23%. The quality of the records was moderate (n = 9) and good (n = 19). The pooled prevalence of poor sleep quality was 37% (95% CI: 30-45%) with significant heterogeneity between the studies (I² = 99.70%, P _{heterogeneity} < 0.001). The subgroup analysis indicated that geographic location was a significant source of heterogeneity (p < 0.001), with a lower prevalence of poor sleep quality observed in Asia (30%; 95% CI = 23%-38%) when compared to other regions. No significant differences were observed in the impact of other factors, including gender, development level, sample size, survey time, PSQI cut-off, response rate, and quality score, on the overall heterogeneity of the analyzed data.

The present study is a first for providing a comprehensive overview of the problem of poor sleep quality among adolescents, with a large sample size and consistent definitions and measurements.