A Meta-Analysis of Sleep Disturbances in Panic Disorder

Abstract

The nature and prevalence of sleep disturbances in panic disorder (PD) have been often discussed but remain unclear. The objective of this systematic review and meta-analysis is to document sleep disturbances in PD. Systematic database search and standardized extraction were conducted. Meta-analysis was computed on self-report (subjective) and polysomnographic (PSG) (objective) data and on prevalence rates of nocturnal panic attacks (NPA). Of the 1262 publications retrieved, 31 were included. PD patients were compared to healthy controls on subjective and objective measures. Patients had higher Pittsburgh sleep quality index (PSQI) global scores (hedges’ g = 1.306, 95% CI [0.532, 2.081]), longer PSG sleep latency (hedges’ g = 0.81, 95% CI [0.576, 1.035]), poorer PSG sleep efficiency (hedges’ g = − 0.79, 95% CI [ − 1.124, − 0.432]), and shorter stage 2 (hedges’ g = 0.70, 95% CI [ − 1.231, − 0.120]) and total sleep time (hedges’ g = − 0.739, 95% CI [ − 1.127, − 0.351]). Among patients, 52.1% (95% CI [0.464, 0.577]) reported NPA ( ≥ 1/lifetime). Patients with PD demonstrate subjective and objective sleep alterations. More than half have experienced NPA. These sleep disturbances could have a significant role in maintaining PD symptoms.