Keywords
Insomnia
Prevalence
University students
Systematic review
South Asia
Prevalence
University students
Systematic review
South Asia
Abstract
Introduction: Insomnia is a global health problem among university students which is associated with various psychiatric problems like depression and anxiety. While different developed and developing countries assessed the prevalence of insomnia in youth, there is currently no systematic review of studies on the prevalence of insomnia in South Asia.
Aims: The aim of this study is to systematically review the evidence relating to the prevalence rate of insomnia in university students in South Asian countries.
Methods: Electronic searches of three databases, PubMed, Cochrane library and Worldwide science were performed from 2010 to 2020 before April. In total, six studies were included for evaluating insomnia in South Asian region among university students.
Result: The prevalence rates of insomnia of the six studies ranged between 35.4% (95%CI: 32.4-38.5%) and 70% (95%CI: 65.7-74.1%). The pooled prevalence of insomnia among university students was 49.1% (95%CI: 38.1-60.2%).
Conclusion: This review emphasized that insomnia in university students might be a common health issue to give full concentration to their studies and academic performance thus, more attention should be given to the determinants of insomnia among university students, so that it could be helpful to identify the main causes of insomnia and effective measures could be taken.
References
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2. Mason EC, Harvey AG. Insomnia before and after treatment for anxiety and depression. Journal of affective disorders. 2014;168:415-21
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4. Terauchi M, Hiramitsu S, Akiyoshi M, Owa Y, Kato K, Obayashi S, et al. Associations between anxiety, depression and insomnia in peri-and post-menopausal women. Maturitas. 2012;72(1):61-5
5. Wali S, Krayem A, Samman Y, Mirdad S, Alshimemeri A, Almobaireek A. Sleep disorders in Saudi health care workers. Annals of Saudi medicine. 1999;19(5):406-9
6. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep medicine reviews. 2002;6(2):97-111
7. Jiang X-L, Zheng X-Y, Yang J, Ye C-P, Chen Y-y, Zhang Z-G, et al. A systematic review of studies on the prevalence of insomnia in university students. Public health. 2015;129(12):1579-84
8. Siomos KE, Avagianou P-A, Floros GD, Skenteris N, Mouzas OD, Theodorou K, et al. Psychosocial correlates of insomnia in an adolescent population. Child Psychiatry & Human Development. 2010;41(3):262-73
9. Brunborg GS, Mentzoni RA, Molde H, Myrseth H, Skouverøe KJM, Bjorvatn B, et al. The relationship between media use in the bedroom, sleep habits and symptoms of insomnia. Journal of sleep research. 2011;20(4):569-75
10. Jha RK, Shah DK, Basnet S, Paudel KR, Sah P, Sah AK, et al. Facebook use and its effects on the life of health science students in a private medical college of Nepal. BMC research notes. 2016;9(1):378
11. Carney CE, Moss TG, Lachowski AM, Atwood ME. Understanding mental and physical fatigue complaints in those with depression and insomnia. Behavioral sleep medicine. 2014;12(4):272-89
12. Sivertsen B, Krokstad S, Øverland S, Mykletun A. The epidemiology of insomnia: Associations with physical and mental health.: The HUNT-2 study. Journal of psychosomatic research. 2009;67(2):109-16
13. Sweileh WM, Ali IA, Sawalha AF, Abu-Taha AS, Sa'ed HZ, Al-Jabi SW. Sleep habits and sleep problems among Palestinian students. Child and adolescent psychiatry and mental health. 2011;5(1):25
14. Tootoonchian F. Evaluation of effect of sleep hygiene education program on insomnia, daytime sleepiness and sleep quality in shift work nurses. journal qums. 2015
15. Tsai L-L, Li S-P. Sleep patterns in college students: Gender and grade differences. Journal of psychosomatic research. 2004;56(2):231-7
16. Galambos NL, Vargas Lascano DI, Howard AL, Maggs JL. Who sleeps best? Longitudinal patterns and covariates of change in sleep quantity, quality, and timing across four university years. Behavioral Sleep Medicine. 2013;11(1):8-22
17. Jhaveri M, Seal B, Pollack M, Wertz D. Will insomnia treatments produce overall cost savings to commercial managed-care plans? A predictive analysis in the United States. Current medical research and opinion. 2007;23(6):1431-43
18. Siriwardena AN, Apekey T, Tilling M, Harrison A, Dyas JV, Middleton HC, et al. Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial. BMC family practice. 2009;10(1):9
19. BaHammam A, Bin Saeed A, Al-Faris E, Shaikh S. Sleep duration and its correlates in a sample of Saudi elementary school children. Singapore medical journal. 2006;47(10):875
20. Navelet Y. Insomnia in the child and adolescent. Sleep. 1996;19(suppl_3):S723-S8
21. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999;22:S347-53
22. Schlarb AA, Kulessa D, Gulewitsch MD. Sleep characteristics, sleep problems, and associations of self-efficacy among German university students. Nature and science of sleep. 2012;4:1
23. Buboltz Jr WC, Brown F, Soper B. Sleep habits and patterns of college students: a preliminary study. Journal of American college health. 2001;50(3):131-5
24. Ohayon MM, Hong S-C. Prevalence of insomnia and associated factors in South Korea. Journal of Psychosomatic Research. 2002;53(1):593-600
25. Kim W-H, Kim B-S, Kim S-K, Chang S-M, Lee D-W, Cho M-J, et al. Prevalence of insomnia and associated factors in a community sample of elderly individuals in South Korea. International psychogeriatrics. 2013;25(10):1729-37
26. Vand HDA, Gharraee B, Farid A-AA, Bandi MG. Prediction of insomnia severity based on cognitive, metacognitive, and emotional variables in college students. Explore. 2014;10(4):233-40
27. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. Journal of psychiatric research. 2013;47(3):391-400
28. Nadeem A, Cheema MK, Naseer M, Javed H. Comparison of quality of sleep between medical and non-medical undergraduate Pakistani students. JPMA The Journal of the Pakistan Medical Association. 2018;68(10):1465-70
29. Bhandari PM, Neupane D, Rijal S, Thapa K, Mishra SR, Poudyal AK. Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal. BMC psychiatry. 2017;17(1):106
30. Ghrouz AK, Noohu MM, Manzar MD, Spence DW, BaHammam AS, Pandi-Perumal SR. Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing. 2019;23(2):627-34
31. Kumar A, Vandana ANA. Analgesics self-medication and its association with sleep quality among medical undergraduates. Journal of clinical and diagnostic research: JCDR. 2016;10(12):FC07
32. Surani AA, Zahid S, Surani A, Ali S, Mubeen M, Khan RH. Sleep quality among medical students of Karachi, Pakistan. J Pak Med Assoc. 2015;65(4):380-2
33. Patil A, Bhavya SC, Srivastava S. Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students. Industrial Psychiatry Journal. 2019;28(1):68
34. Vélez JC, Souza A, Traslaviña S, Barbosa C, Wosu A, Andrade A, et al. The epidemiology of sleep quality and consumption of stimulant beverages among Patagonian Chilean college students. Sleep disorders. 2013;2013
35. Kabrita C. T.; Duffy, JF; Hajjar-Muça, T. Predictors of poor sleep quality among Lebanese university students: Association between evening typology, lifestyle behaviors, and sleep habits. Nat Sci Sleep. 2014;6:11-8
36. Waqas A, Khan S, Sharif W, Khalid U, Ali A. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey. PeerJ. 2015;3:e840
37. Gaultney JF. The prevalence of sleep disorders in college students: impact on academic performance. Journal of American College Health. 2010;59(2):91-7
38. Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Sleep quality of Chinese adolescents: distribution and its associated factors. Journal of paediatrics and child health. 2012;48(2):138-45
39. Pallos H, Gergely V, Yamada N, Miyazaki S, Okawa M. The quality of sleep and factors associated with poor sleep in Japanese graduate students. Sleep and Biological Rhythms. 2007;5(4):234-8
40. Voelker R. Stress, sleep loss, and substance abuse create potent recipe for college depression. Jama. 2004;291(18):2177-9
41. Schmidt RE, Gay P, Van der Linden M. Facets of impulsivity are differentially linked to insomnia: Evidence from an exploratory study. Behavioral sleep medicine. 2008;6(3):178-92
42. Fernández-Mendoza J, Vela-Bueno A, Vgontzas AN, Olavarrieta-Bernardino S, Ramos-Platón MJ, Bixler EO, et al. Nighttime sleep and daytime functioning correlates of the insomnia complaint in young adults. Journal of adolescence. 2009;32(5):1059-74
43. Schmidt RE, Gay P, Ghisletta P, Van der Linden M. Linking impulsivity to dysfunctional thought control and insomnia: a structural equation model. Journal of Sleep Research. 2010;19(1‐Part‐I):3-11
44. Gellis LA, Arigo D, Elliott JC. Cognitive refocusing treatment for insomnia: A randomized controlled trial in university students. Behavior Therapy. 2013;44(1):100-10
45. Pramanik T, Sherpa M, Shrestha R. Internet addiction in a group of medical students: a cross sectional study. Nepal Medical College Journal: NMCJ. 2012;14(1):46-8
46. Jaussent I, Dauvilliers Y, Ancelin M-L, Dartigues J-F, Tavernier B, Touchon J, et al. Insomnia symptoms in older adults: associated factors and gender differences. The American Journal of Geriatric Psychiatry. 2011;19(1):88-97
47. Johansson P, Årestedt K, Alehagen U, Svanborg E, Dahlström U, Broström A. Sleep disordered breathing, insomnia, and health related quality of life—A comparison between age and gender matched elderly with heart failure or without cardiovascular disease. European Journal of Cardiovascular Nursing. 2010;9(2):108-17
48. Yoshioka E, Saijo Y, Kita T, Satoh H, Kawaharada M, Fukui T, et al. Gender differences in insomnia and the role of paid work and family responsibilities. Social psychiatry and psychiatric epidemiology. 2012;47(4):651-62
49. Suen LK, Ellis Hon K, Tam WW. Association between sleep behavior and sleep‐related factors among university students in Hong Kong. Chronobiology international. 2008;25(5):760-75
50. Committee on Improving the Health S, Bonnie R, Stroud C, Breiner H, Council NR. Investing in the health and well-being of young adults: National Academies Press (US); 2015.
51. Cain N, Gradisar M. Electronic media use and sleep in school-aged children and adolescents: A review. Sleep medicine. 2010;11(8):735-42
2. Mason EC, Harvey AG. Insomnia before and after treatment for anxiety and depression. Journal of affective disorders. 2014;168:415-21
3. Øyane NM, Pallesen S, Moen BE, Åkerstedt T, Bjorvatn B. Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses. PLoS one. 2013;8(8)
4. Terauchi M, Hiramitsu S, Akiyoshi M, Owa Y, Kato K, Obayashi S, et al. Associations between anxiety, depression and insomnia in peri-and post-menopausal women. Maturitas. 2012;72(1):61-5
5. Wali S, Krayem A, Samman Y, Mirdad S, Alshimemeri A, Almobaireek A. Sleep disorders in Saudi health care workers. Annals of Saudi medicine. 1999;19(5):406-9
6. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep medicine reviews. 2002;6(2):97-111
7. Jiang X-L, Zheng X-Y, Yang J, Ye C-P, Chen Y-y, Zhang Z-G, et al. A systematic review of studies on the prevalence of insomnia in university students. Public health. 2015;129(12):1579-84
8. Siomos KE, Avagianou P-A, Floros GD, Skenteris N, Mouzas OD, Theodorou K, et al. Psychosocial correlates of insomnia in an adolescent population. Child Psychiatry & Human Development. 2010;41(3):262-73
9. Brunborg GS, Mentzoni RA, Molde H, Myrseth H, Skouverøe KJM, Bjorvatn B, et al. The relationship between media use in the bedroom, sleep habits and symptoms of insomnia. Journal of sleep research. 2011;20(4):569-75
10. Jha RK, Shah DK, Basnet S, Paudel KR, Sah P, Sah AK, et al. Facebook use and its effects on the life of health science students in a private medical college of Nepal. BMC research notes. 2016;9(1):378
11. Carney CE, Moss TG, Lachowski AM, Atwood ME. Understanding mental and physical fatigue complaints in those with depression and insomnia. Behavioral sleep medicine. 2014;12(4):272-89
12. Sivertsen B, Krokstad S, Øverland S, Mykletun A. The epidemiology of insomnia: Associations with physical and mental health.: The HUNT-2 study. Journal of psychosomatic research. 2009;67(2):109-16
13. Sweileh WM, Ali IA, Sawalha AF, Abu-Taha AS, Sa'ed HZ, Al-Jabi SW. Sleep habits and sleep problems among Palestinian students. Child and adolescent psychiatry and mental health. 2011;5(1):25
14. Tootoonchian F. Evaluation of effect of sleep hygiene education program on insomnia, daytime sleepiness and sleep quality in shift work nurses. journal qums. 2015
15. Tsai L-L, Li S-P. Sleep patterns in college students: Gender and grade differences. Journal of psychosomatic research. 2004;56(2):231-7
16. Galambos NL, Vargas Lascano DI, Howard AL, Maggs JL. Who sleeps best? Longitudinal patterns and covariates of change in sleep quantity, quality, and timing across four university years. Behavioral Sleep Medicine. 2013;11(1):8-22
17. Jhaveri M, Seal B, Pollack M, Wertz D. Will insomnia treatments produce overall cost savings to commercial managed-care plans? A predictive analysis in the United States. Current medical research and opinion. 2007;23(6):1431-43
18. Siriwardena AN, Apekey T, Tilling M, Harrison A, Dyas JV, Middleton HC, et al. Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial. BMC family practice. 2009;10(1):9
19. BaHammam A, Bin Saeed A, Al-Faris E, Shaikh S. Sleep duration and its correlates in a sample of Saudi elementary school children. Singapore medical journal. 2006;47(10):875
20. Navelet Y. Insomnia in the child and adolescent. Sleep. 1996;19(suppl_3):S723-S8
21. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999;22:S347-53
22. Schlarb AA, Kulessa D, Gulewitsch MD. Sleep characteristics, sleep problems, and associations of self-efficacy among German university students. Nature and science of sleep. 2012;4:1
23. Buboltz Jr WC, Brown F, Soper B. Sleep habits and patterns of college students: a preliminary study. Journal of American college health. 2001;50(3):131-5
24. Ohayon MM, Hong S-C. Prevalence of insomnia and associated factors in South Korea. Journal of Psychosomatic Research. 2002;53(1):593-600
25. Kim W-H, Kim B-S, Kim S-K, Chang S-M, Lee D-W, Cho M-J, et al. Prevalence of insomnia and associated factors in a community sample of elderly individuals in South Korea. International psychogeriatrics. 2013;25(10):1729-37
26. Vand HDA, Gharraee B, Farid A-AA, Bandi MG. Prediction of insomnia severity based on cognitive, metacognitive, and emotional variables in college students. Explore. 2014;10(4):233-40
27. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. Journal of psychiatric research. 2013;47(3):391-400
28. Nadeem A, Cheema MK, Naseer M, Javed H. Comparison of quality of sleep between medical and non-medical undergraduate Pakistani students. JPMA The Journal of the Pakistan Medical Association. 2018;68(10):1465-70
29. Bhandari PM, Neupane D, Rijal S, Thapa K, Mishra SR, Poudyal AK. Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal. BMC psychiatry. 2017;17(1):106
30. Ghrouz AK, Noohu MM, Manzar MD, Spence DW, BaHammam AS, Pandi-Perumal SR. Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing. 2019;23(2):627-34
31. Kumar A, Vandana ANA. Analgesics self-medication and its association with sleep quality among medical undergraduates. Journal of clinical and diagnostic research: JCDR. 2016;10(12):FC07
32. Surani AA, Zahid S, Surani A, Ali S, Mubeen M, Khan RH. Sleep quality among medical students of Karachi, Pakistan. J Pak Med Assoc. 2015;65(4):380-2
33. Patil A, Bhavya SC, Srivastava S. Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students. Industrial Psychiatry Journal. 2019;28(1):68
34. Vélez JC, Souza A, Traslaviña S, Barbosa C, Wosu A, Andrade A, et al. The epidemiology of sleep quality and consumption of stimulant beverages among Patagonian Chilean college students. Sleep disorders. 2013;2013
35. Kabrita C. T.; Duffy, JF; Hajjar-Muça, T. Predictors of poor sleep quality among Lebanese university students: Association between evening typology, lifestyle behaviors, and sleep habits. Nat Sci Sleep. 2014;6:11-8
36. Waqas A, Khan S, Sharif W, Khalid U, Ali A. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey. PeerJ. 2015;3:e840
37. Gaultney JF. The prevalence of sleep disorders in college students: impact on academic performance. Journal of American College Health. 2010;59(2):91-7
38. Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Sleep quality of Chinese adolescents: distribution and its associated factors. Journal of paediatrics and child health. 2012;48(2):138-45
39. Pallos H, Gergely V, Yamada N, Miyazaki S, Okawa M. The quality of sleep and factors associated with poor sleep in Japanese graduate students. Sleep and Biological Rhythms. 2007;5(4):234-8
40. Voelker R. Stress, sleep loss, and substance abuse create potent recipe for college depression. Jama. 2004;291(18):2177-9
41. Schmidt RE, Gay P, Van der Linden M. Facets of impulsivity are differentially linked to insomnia: Evidence from an exploratory study. Behavioral sleep medicine. 2008;6(3):178-92
42. Fernández-Mendoza J, Vela-Bueno A, Vgontzas AN, Olavarrieta-Bernardino S, Ramos-Platón MJ, Bixler EO, et al. Nighttime sleep and daytime functioning correlates of the insomnia complaint in young adults. Journal of adolescence. 2009;32(5):1059-74
43. Schmidt RE, Gay P, Ghisletta P, Van der Linden M. Linking impulsivity to dysfunctional thought control and insomnia: a structural equation model. Journal of Sleep Research. 2010;19(1‐Part‐I):3-11
44. Gellis LA, Arigo D, Elliott JC. Cognitive refocusing treatment for insomnia: A randomized controlled trial in university students. Behavior Therapy. 2013;44(1):100-10
45. Pramanik T, Sherpa M, Shrestha R. Internet addiction in a group of medical students: a cross sectional study. Nepal Medical College Journal: NMCJ. 2012;14(1):46-8
46. Jaussent I, Dauvilliers Y, Ancelin M-L, Dartigues J-F, Tavernier B, Touchon J, et al. Insomnia symptoms in older adults: associated factors and gender differences. The American Journal of Geriatric Psychiatry. 2011;19(1):88-97
47. Johansson P, Årestedt K, Alehagen U, Svanborg E, Dahlström U, Broström A. Sleep disordered breathing, insomnia, and health related quality of life—A comparison between age and gender matched elderly with heart failure or without cardiovascular disease. European Journal of Cardiovascular Nursing. 2010;9(2):108-17
48. Yoshioka E, Saijo Y, Kita T, Satoh H, Kawaharada M, Fukui T, et al. Gender differences in insomnia and the role of paid work and family responsibilities. Social psychiatry and psychiatric epidemiology. 2012;47(4):651-62
49. Suen LK, Ellis Hon K, Tam WW. Association between sleep behavior and sleep‐related factors among university students in Hong Kong. Chronobiology international. 2008;25(5):760-75
50. Committee on Improving the Health S, Bonnie R, Stroud C, Breiner H, Council NR. Investing in the health and well-being of young adults: National Academies Press (US); 2015.
51. Cain N, Gradisar M. Electronic media use and sleep in school-aged children and adolescents: A review. Sleep medicine. 2010;11(8):735-42