The Prevalence of Sleep Disorders Among Children in Mainland China: A Meta-analysis and Systemic-analysis

Abstract Background: We conducted a meta-analysis and systematic review to identify a reliable estimate of sleep disorders prevalence among children in mainland China and to describe its epidemiological characteristics. Methods: Relevant studies were searched thoroughly via electronic databases included China National Knowledge Infrastructure, Wanfang,Weipu,PubMed,Web of Science and Medline databases from inception until December 2020.Prevalence estimates were calculated by random-effects models. The sources of heterogeneity were explored using subgroup analyses and Meta-regression analysis, and publication bias was estimated by funnel plots and Egger’s Test. Results: Overall, 66 studies were included in this meta-analysis, which revealed that the pooled prevalence of sleep disorders was 37.6% (95%CI: 34.3-40.9%)with high heterogeneity ( I 2 =99.6%, P =0.000).The prevalence rate of sleep disorders among males was higher than females (OR:1.01,95%CI:1.05-1.13).In all age groups, the prevalence rates of sleep disorders increased with age, including infancy or early childhood group(33.3%),pre-school group(38.9%), school-age group(43.7%). The prevalence rate in South China (30.4%, 95%CI: 23.9–36.8%) was the lowest, and the highest prevalence rate was in West China (47.4 %,95%CI:35.9–58.9%), which than any other region in China. The point estimate for sleep disorders prevalence obtained using the CSHQ criterion was higher than other criteria.Meta-regression indicated that age group could influence prevalence estimation ( P = 0.011). Conclusions: Over the past two decades, the prevalence rate of sleep disorders among children in mainland China has increased, significantly affecting two-fifth of the school-age children. The prevalence rate of sleep disorders in west China was significantly higher than in any other area. There is still a lack of guidelines on children's sleep disorders in mainland China, so future research should pay special attention to the sleep disorders of school-age children and children in economically backward areas.