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

Research output: Journal article publicationReview articleAcademic researchpeer-review

14 Citations (Scopus)


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.

Original languageEnglish
Article number104513
JournalNeuroscience and Biobehavioral Reviews
Publication statusPublished - Feb 2022


  • Alexithymia
  • Meta-analysis
  • Sleep disturbances
  • Sleep problems
  • Sleep quality
  • Systematic review

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience


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