text: Impact of COVID 19 pandemic on sleep in children and adolescents a systematic review and meta analysis This systematic review and meta analysis were conducted to study the prevalence and pattern of sleep disturbances in children and adolescents during the COVID 19 pandemic MEDLINE EMBASE and Web of Science were searched for original studies describing sleep abnormalities in children and adolescents with or without pre existing neurobehavioral disorders during the COVID 19 pandemic The pooled estimates for various sleep abnormalities were calculated using a random effect model Of 371 articles screened 16 studies were included Among these five studies were in preschool children two were in children with pre existing neurobehavioral disorders and the remaining were in school going children and adolescents The outcome measures used for sleep were markedly heterogeneous across the studies The pooled prevalence of any sleep disturbance in children during the pandemic was 54 95 CI 50 57 Interestingly the prevalence in pre school children was lower than pre pandemic times RR 0 87 95 CI 0 58 1 30 but this was not statistically significant The pooled prevalence of children not meeting sleep recommendation was 49 95 CI 39 58 The prevalence of sleep problems in children and adolescents during the COVID 19 pandemic is alarming Pre school children had a trend towards relatively fewer sleep disturbances due to home confinement measures in comparison with pre pandemic times Sleep duration recommendations were not met in nearly half of healthy children However these conclusions need to be seen in light of limited literature on the topic few included studies done in heterogenous populations and dubious quality of inferences drawn from these studies which were predominantly online surveys CRD42020213788 