Zeng Liang-Nan, Zong Qian-Qian, Yang Yuan, Zhang Ling, Xiang Yi-Fan, Ng Chee H, Chen Li-Gang, Xiang Yu-Tao
Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Neurosurgery Clinical Medical Research Center of Sichuan Province, Academician (Expert) Workstation of Sichuan Province, Luzhou, China.
Front Psychiatry. 2020 Nov 20;11:577429. doi: 10.3389/fpsyt.2020.577429. eCollection 2020.
Insomnia is a major health challenge in the general population, but the results of the gender differences in the epidemiology of insomnia have been mixed. This is a meta-analysis to examine the gender difference in the prevalence of insomnia among the general population. Two reviewers independently searched relevant publications in PubMed, EMBASE, PsycINFO, Web of Science from their inception to 16 April 2019. Studies that reported the gender-based prevalence of insomnia according to the international diagnostic criteria were included for analyses using the random-effects model. Eventually 13 articles were included in the meta-analysis. The pooled prevalence of insomnia in the general population was 22.0% [ = 22,980, 95% confidence interval (CI): 17.0-28.0%], and females had a significantly higher prevalence of insomnia compared with males (OR = 1.58, 95% CI: 1.35, 1.85, = 5.63, < 0.0001). Subgroup analyses showed that greater gender difference was associated with the use of case-control study design and consecutive sampling method. Meta-regression analyses also revealed that higher proportion of females and better study quality were significantly associated with greater gender difference. This meta-analysis found that the prevalence of insomnia in females was significantly higher than males in the included studies. Due to the negative effects of insomnia on health, regular screening, and effective interventions should be implemented in the general population particularly for females.
失眠是普通人群面临的一项重大健康挑战,但失眠流行病学中性别差异的研究结果却参差不齐。本研究通过荟萃分析来探讨普通人群中失眠患病率的性别差异。两名研究者独立检索了PubMed、EMBASE、PsycINFO和Web of Science数据库自建库至2019年4月16日期间的相关文献。纳入依据国际诊断标准报告失眠按性别划分患病率的研究,并采用随机效应模型进行分析。最终,13篇文章被纳入荟萃分析。普通人群中失眠的合并患病率为22.0%[n = 22,980,95%置信区间(CI):17.0 - 28.0%],女性失眠患病率显著高于男性(OR = 1.58,95% CI:1.35,1.85,P = 5.63,P < 0.0001)。亚组分析显示,更大的性别差异与病例对照研究设计及连续抽样方法的使用有关。荟萃回归分析还表明,女性比例较高和研究质量较好与更大的性别差异显著相关。该荟萃分析发现,在纳入的研究中,女性失眠患病率显著高于男性。鉴于失眠对健康的负面影响,应在普通人群中,尤其是女性中开展定期筛查并实施有效干预措施。