Is alexithymia associated with sleep problems? A systematic review and meta-analysis

Zainab Alimoradi; Nilofar Rajabi Majd; Anders Broström; Hector W H Tsang; Parmveer Singh; Maurice M Ohayon; Chung-Ying Lin; Amir H Pakpour

doi:10.1016/j.neubiorev.2021.12.036

Is alexithymia associated with sleep problems? A systematic review and meta-analysis

Neurosci Biobehav Rev. 2022 Feb:133:104513. doi: 10.1016/j.neubiorev.2021.12.036. Epub 2021 Dec 24.

Authors

Zainab Alimoradi¹, Nilofar Rajabi Majd², Anders Broström³, Hector W H Tsang⁴, Parmveer Singh⁵, Maurice M Ohayon⁶, Chung-Ying Lin⁷, Amir H Pakpour⁸

Affiliations

¹ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran. Electronic address: Zainabalimoradi@yahoo.com.
² Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran.
³ Department of Nursing, School of Health and Welfare, Jönköping University, 55111 Jönköping, Sweden; Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden. Electronic address: anders.brostrom@ju.se.
⁴ Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong. Electronic address: hector.tsang@polyu.edu.hk.
⁵ P. G. Department of Agriculture, Khalsa College Amritsar, Punjab, India. Electronic address: parmveersingh@khalsacollege.edu.in.
⁶ Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA. Electronic address: mohayon@stanford.edu.
⁷ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: cylin36933@gmail.com.
⁸ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, 55111 Jönköping, Sweden. Electronic address: amir.pakpour@ju.se.

PMID: 34958823
DOI: 10.1016/j.neubiorev.2021.12.036

Abstract

Alexithymia, a difficulty identifying and expressing emotions experienced by oneself or others, measurably harms quality of sleep. Research has observed the association between alexithymia and sleep problems; however, the cumulative effect of this association is still unknown. Therefore, this systematic review and meta-analysis was conducted to present scientific evidence regarding the relationship between alexithymia and sleep quality. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and using relevant keywords, we searched six databases: Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, EMBASE, and Science Direct. We selected observational studies on the association between alexithymia and sleep. We conducted meta-analysis using a random-effect model to calculate the effect size (ES) with Fisher's z transformation. Eligible studies (N = 26) in 24 papers included 7546 participants from 12 countries. The entire ES for the association between alexithymia and sleep was 0.44 (95 % CI: 0.31, 0.56). Additionally, patient populations had a larger ES (ES = 0.55; 95 % CI: 0.30, 0.79) than healthy populations (ES = 0.30; 95 % CI: 0.20, 0.41). The results of the present systematic review and meta-analysis revealed a significant association between alexithymia and sleep problems, especially among people with any medical condition.

Keywords: Alexithymia; Meta-analysis; Sleep disturbances; Sleep problems; Sleep quality; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Affective Symptoms* / complications
Humans
Sleep
Sleep Quality
Sleep Wake Disorders* / complications
Sleep Wake Disorders* / psychology