Impact of the COVID-19 pandemic on the sleep quality of students: A meta-analysis and meta-regression.

Objective: The present systematic review aims to assess the impact of the COVID19 pandemic on the sleep quality of students.

Methods: An electronic search was performed in the databases and in gray literature for articles published up to January 2022. The results included observational studies that assessed sleep quality through validated questionnaires, comparing moments pre and postCOVID19 pandemic. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. The Grading of Assessment, Development and Evaluation (GRADE) was used to assess the certainty of scientific evidence. Estimates of interest were calculated using random effects meta-analyses and possible confounding factors were meta-regressed.

Results: Eighteen studies were considered for qualitative synthesis and thirteen were considered for meta-analysis. Considering the comparison of means obtained by the Pittsburgh Sleep Quality Index, there was an increase in the scores obtained during the pandemic period [MD = -0.39; 95% CI = -0.72 - -0.07; I = 88.31%], thus evidencing a slight worsening in the sleep quality of these individuals. Risk of bias was considered low in nine studies, moderate in eight studies, and high in one study. The unemployment rate (%) in the country of origin of each included study partially explained the heterogeneity of analysis. GRADE analysis showed a very low certainty of scientific evidence.

Conclusion: The COVID-19 pandemic may have a slight negative impact on the sleep quality of high school and college students, but the evidence is still uncertain. The socioeconomic reality must be considered when evaluating this outcome.