Table 2.
Univariate Random-effects Meta-regression for the Prevalence of Insomnia According to Age Categories, CKD Stage, WHO Regions, Risk of Bias, and Diagnostic Criteria of Insomnia
| Variables | No. of Studies | Beta Estimates (95% CI) | Prevalence (95% CI) | P Value | I2, % |
|---|---|---|---|---|---|
| Age,Y | |||||
| Per 1-y increase | 45 | 0.01 (0.00 to 0.02) | 0.42 (0.36 to 0.49) | 0.21 | 99.11 |
| <50 | 8 | Ref | 0.24 (0.12 to 0.38) | Ref | 98.64 |
| 51-60 | 24 | 0.26 (0.09 to 0.43) | 0.49 (0.40 to 0.57) | 0.003 | |
| >60 | 13 | 0.19 (0.00 to 0.37) | 0.41 (0.30 to 0.53) | 0.05 | |
| CKD stage | 98.71 | ||||
| Control | 5 | −0.10 (−0.36 to 0.17) | 0.18 (0.07 to 0.34) | 0.49 | |
| Kidney transplantation | 4 | Ref | 0.26 (0.11 to 0.46) | Ref | |
| CKD without KRT | 4 | 0.23 (−0.06 to 0.52) | 0.49 (0.29 to 0.69) | 0.12 | |
| Hemodialysis | 25 | 0.21 (−0.01 to 0.43) | 0.46 (0.39 to 0.55) | 0.06 | |
| Peritoneal dialysis | 4 | 0.35 (0.06 to 0.64) | 0.61 (0.40 to 0.80) | 0.02 | |
| CKD with or without KRT | 4 | 0.07 (−0.21 to 0.35) | 0.33 (0.16 to 0.52) | 0.63 | |
| WHO regionsa | 97.67 | ||||
| European | 15 | Ref | 0.32 (0.23 to 0.41) | Ref | |
| Americas | 7 | 0.24 (0.08 to 0.40) | 0.56 (0.42 to 0.69) | 0.003 | |
| Western Pacific | 3 | 0.36 (0.13 to 0.59) | 0.67 (0.47 to 0.85) | 0.002 | |
| Eastern Mediterranean | 8 | 0.17 (0.02 to 0.33) | 0.49 (0.36 to 0.62) | 0.03 | |
| South-East Asia Region | 1 | 0.04 (−0.33 to 0.41) | 0.36 (0.07 to 0.71) | 0.83 | |
| Risk of bias | 98.47 | ||||
| Low | 7 | Ref | 0.50 (0.35 to 0.65) | Ref | |
| Moderate | 13 | −0.15 (−0.34 to 0.03) | 0.35 (0.25 to 0.46) | 0.10 | |
| High | 15 | −0.01 (−0.19 to 0.17) | 0.49 (0.39 to 0.59) | 0.93 | |
| Diagnostic criteria of insomnia | 98.66 | ||||
| Complaint-basedb | 16 | Ref | 0.49 (0.38 to 0.59) | Ref | |
| Diagnostic tool–basedc | 19 | −0.09 (−0.23 to 0.05) | 0.40 (0.31 to 0.49) | 0.21 |
Abbreviations: CKD, chronic kidney disease; KRT, kidney replacement therapy; Ref, reference; WHO, World Health Organization.
In our analysis of WHO regions, we excluded the study by Elder et al,15 which comprised data from 3 WHO regions.
Primary criteria (difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and nonrestorative sleep), together with at least 1 of the secondary criteria listed in Table S2.
Included the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; International Classification of Sleep Disorders, version 2; Athens Insomnia Scale; and Insomnia Severity Index.