Zhang Qian-Qian, Li Lan, Zhong Bao-Liang
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Front Med (Lausanne). 2021 Nov 15;8:779914. doi: 10.3389/fmed.2021.779914. eCollection 2021.
The ongoing COVID-19 pandemic has disproportionately affected the sleep health of older adults, but the limited number of studies on insomnia symptoms of older Chinese adults differed in terms of screener of insomnia, sample size, and prevalence, making mental health planning for this population difficult. This meta-analysis estimated the prevalence of insomnia symptoms in older Chinese adults during the COVID-19 pandemic. Both Chinese (CNKI, Wanfang, VIP) and English (PubMed, EmBase, PsycInfo) databases were systematically searched to identify cross-sectional studies containing data on the prevalence of insomnia symptoms in older Chinese adults during the pandemic. Risk of bias (RoB) of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Nine studies with a total of 27,207 older Chinese adults were included. RoB scores of these studies ranged between zero and six. The pooled prevalence rates of insomnia symptoms and moderate and severe insomnia symptoms were 24.6% [95% confidence interval (CI): 19.5-30.5%] and 11.1% (95% CI: 7.2-16.9%), respectively. In subgroup analysis, significantly higher prevalence rates were observed in studies defining insomnia symptoms as "Insomnia Severity Index (ISI) ≥ 8" than in those defining them as "ISI ≥ 15" (32.6 vs. 15.6%, < 0.001) and in older adults living in the COVID-19 epicenter than in those living in other places (35.2 vs. 23.3%, = 0.006). Nearly one out of every four older Chinese adults suffered from insomnia symptoms during the pandemic. Mental health services for this population during the pandemic should include supportive activities aimed at improving mental well-being, periodic assessment of insomnia symptoms, and psychiatric assessment and treatment when necessary.
持续的新冠疫情对老年人的睡眠健康产生了尤为严重的影响，但针对中国老年人群失眠症状的研究数量有限，在失眠筛查工具、样本量和患病率方面存在差异，这使得为该人群制定心理健康计划变得困难。本荟萃分析估计了新冠疫情期间中国老年人群失眠症状的患病率。我们系统检索了中文数据库（中国知网、万方、维普）和英文数据库（PubMed、EmBase、PsycInfo），以识别包含疫情期间中国老年人群失眠症状患病率数据的横断面研究。采用乔安娜·布里格斯研究所（Joanna Briggs Institute）的患病率数据报告研究批判性评价清单对纳入研究的偏倚风险进行评估。纳入了9项研究，共计27207名中国老年人。这些研究的偏倚风险评分为0至6分。失眠症状以及中度和重度失眠症状的合并患病率分别为24.6% [95%置信区间（CI）：19.5 - 30.5%]和11.1%（95% CI：7.2 - 16.9%）。在亚组分析中，将失眠症状定义为“失眠严重程度指数（ISI）≥ 8”的研究中的患病率显著高于将其定义为“ISI ≥ 15”的研究（32.6%对15.6%，< 0.001），且生活在新冠疫情中心地区的老年人的患病率高于生活在其他地区的老年人（35.2%对23.3%， = 0.006）。在疫情期间，每四名中国老年人中就有近一人患有失眠症状。疫情期间针对该人群的心理健康服务应包括旨在改善心理健康的支持性活动、定期评估失眠症状以及必要时进行精神科评估和治疗。
