Abstract
Objectives: Healthcare workers (HWs) experienced high levels of work stress during the COVID-19 pandemic, leading to a high risk of sleep disturbances. This meta-analysis aimed to explore the prevalence of sleep disturbances and sleep quality in Chinese HWs during the COVID-19 pandemic.Methods: English (PubMed, EMBASE, PsycINFO, Web of Science, and the Cochrane Library) and Chinese databases (WanFang, Chinese National Knowledge Infrastructure, and SinoMed) were systematically and independently searched for relevant studies published from December 1, 2019, to May 20, 2020. The pooled prevalence of sleep disturbances and sleep quality were calculated using a random-effects model.Results: A total of 17 studies involving 12,682 Chinese HWs were included in the meta-analysis. The pooled prevalence of sleep disturbances in Chinese HWs was 45.1% (95% CI: 37.2–53.1%). We found that the prevalence of sleep disturbances varied among frontline, infected, and non-frontline HWs (Q = 96.96, p < 0.001); females and males (Q = 9.10, p = 0.003); studies using different assessment instruments (Q = 96.05, p < 0.001); and studies with different sample sizes (Q = 5.77, p = 0.016) and cut-off values (Q = 62.28, p < 0.001). The pooled mean total score of the Pittsburgh Sleep Quality Index (PSQI) was 9.83 (95% CI: 8.61–11.04). HWs in Wuhan had a higher total PSQI score than those in other regions (Q = 9.21, p = 0.002).Conclusion: Sleep disturbances were common in Chinese HWs during the COVID-19 pandemic, particularly in frontline and infected HWs. Our results indicate the heavy mental health burden on HWs during the COVID-19 pandemic in China and can provide other countries with valuable information to assist HWs during the crisis.
Highlights
In December 2019, the 2019 novel coronavirus disease (COVID19) was officially reported for the first time in Wuhan, Hubei Province, China; it spread rapidly worldwide [1]
Studies were included if they fulfilled the following criteria: (a) the subjects were healthcare workers (HWs), including doctors, nurses, and other HWs, who worked in hospitals or other medical institutes; (b) the studies had cross-sectional or cohort study designs and conducted in China during the COVID19 pandemic; (c) the studies included data on the prevalence of sleep disturbances as measured by sleep questionnaires or standard diagnostic criteria, and/or sleep quality was measured by the PSQI with means and standard deviations reported
The prevalence rates of sleep disturbances among frontline, infected, and non-frontline HWs were 57.4%, 97.0%, and 40.0% (Q = 96.96, p < 0.001), respectively
Summary
In December 2019, the 2019 novel coronavirus disease (COVID19) was officially reported for the first time in Wuhan, Hubei Province, China; it spread rapidly worldwide [1]. People have been directed to stay at home to minimize the spread of COVID-19; healthcare workers (HWs) are at high risk of infection due to the nature of their work in fighting the virus. As the number of cases in China increased, HWs had to care for an increasing number of confirmed and suspected cases that required strict isolation. HWs tended to experience excessive fatigue, tension, and even exhaustion [5]. They were worried about themselves and their families being infected, and they were concerned about their family members’ worrying about them. They may have become overexcited in clinical work and refused reasonable rest to ensure their health [6]
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