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

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

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

Materials and methods: 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.

Results: 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.

Conclusion: 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.