Abstract
INTRODUCTION: Osteoarthritis is a leading cause of chronic pain and reduced mobility, especially in weight-bearing joints such as the knees and hips. While physical limitations associated with knee and/or hip osteoarthritis (KHOA) are well-documented, increasing attention is being paid to its impact on sleep disturbances and overall sleep quality. Understanding the extent and nature of these sleep-related issues is essential for the holistic management of knee and/or hip osteoarthritis. This study aims to synthesize current evidence on sleep disturbances and sleep quality in individuals diagnosed with knee and/or hip osteoarthritis. METHODS: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Comprehensive searches were performed across multiple electronic databases, including Medline via PubMed, EMBASE, CINAHL via EBSCO, Scopus, Web of Science, and ScienceDirect. Additionally, gray literature was sourced through Google Scholar, ProQuest, and Sodhaganga. Studies focused on sleep quality, disturbances, and related factors among individuals with KHOA were screened. Finally, 17 articles were included in the final analysis. RESULTS: Depression and elevated pain levels emerged as prominent contributors to sleep disturbances in individuals with KHOA. The meta-analysis revealed a pooled effect size of 8.53 (95% CI: 7.18-9.87) in Pittsburgh Sleep Quality Index (PSQI) scores, indicating significantly poorer sleep quality among patients with knee and/or hip osteoarthritis compared to healthy controls (p < 0.0001). However, there was substantial heterogeneity across studies (I (2) = 94.96%). CONCLUSION: This study highlights that individuals with knee and/or hip osteoarthritis experience significantly impaired sleep quality, primarily driven by pain and psychological factors. The findings underscore the need for integrated clinical approaches that address not only the physical symptoms of OA but also its broader impact on sleep and mental health. SYSTEMATIC REVIEW REGISTRATION: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42024547589].