Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia
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OBJECTIVE: To estimate the prevalence of sleep problems and the effect of potential correlates in low-income settings from Africa and Asia, where the evidence is lacking. DESIGN: Cross-sectional. SETTING: Community-wide samples from 8 countries across Africa and Asia participating in the INDEPTH WHO-SAGE multicenter collaboration during 2006-2007. The participating sites included rural populations in Ghana, Tanzania, South Africa, India, Bangladesh, Vietnam, and Indonesia, and an urban area in Kenya. PARTICIPANTS: There were 24,434 women and 19,501 men age 50 yr and older. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Two measures of sleep quality, over the past 30 days, were assessed alongside a number of sociodemographic variables, measures of quality of life, and comorbidities. Overall, 16.6% of participants reported severe/extreme nocturnal sleep problems, with a striking variation across the 8 populations, ranging from 3.9% (Purworejo, Indonesia and Nairobi, Kenya) to more than 40.0% (Matlab, Bangladesh). There was a consistent pattern of higher prevalence of sleep problems in women and older age groups. In bivariate analyses, lower education, not living in partnership, and poorer self-rated quality of life were consistently associated with higher prevalence of sleep problems (P < 0.001). In multivariate logistic regression analyses, limited physical functionality or greater disability and feelings of depression and anxiety were consistently strong, independent correlates of sleep problems, in both women and men, across the 8 sites (P < 0.001). CONCLUSIONS: A large number of older adults in low-income settings are currently experiencing sleep problems, which emphasizes the global dimension of this emerging public health issue. This study corroborates the multifaceted nature of sleep problems, which are strongly linked to poorer general well-being and quality of life, and psychiatric comorbidities.
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The prevalence of sleep disruption observed in medical students is higher than in the general population.
“The prevalence herein observed is higher than in the general population, which was 16.6% in Asia and Africa prevalence, 62 20% in Canada and the US, 63,64 22.7% in Latin America, 65 23% in Japan, and 31% in Western Europe.66”
From Sleep disruption in medicine students and its relationship with impaired academic performance: A systematic review and meta-analysis. (2020) · cites this paper as [62]
The Results report that 16.6% of participants had nocturnal sleep problems. However, the study sampled adults aged 50–106 at eight sites in Africa and Asia, not the general population across those continents. It does not compare that prevalence with medical students. (LLM, conf=0.87)
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- Authors
- Stranges, S., Tigbe, W., Gómez-Olivé, F. X., Thorogood, M., & Kandala, N.-B.
- Affiliations
- University of Warwick (GB)
- University of the Witwatersrand (ZA)
- Corresponding author
- Stranges, Saverio
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-08
- Volume
- 35
- Issue
- 8
- Pages
- 1173-1181
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3397790
- OpenAlex
- W1978295404
- Semantic Scholar
- 4b02d7fd6541334fb525ca30ba3d8c959d470b48
- Cited by
- 592
- References
- 53
- Citations by year
- 2026: 28 · 2025: 60 · 2024: 52 · 2023: 52 · 2022: 70 · 2021: 59 · 2020: 54 · 2019: 65 · 2018: 37 · 2017: 34 · 2016: 34 · 2015: 12 · 2014: 13 · 2013: 16 · 2012: 6
- FWCI
- 20.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Wellcome Trust (058893, 069683, 058893/Z/ 99/A)
- National Institutes of Health
- National Institute on Aging (058893/Z/99/A)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- sleep disorders, older adults, sleep quality, prevalence, low-income settings, quality of life, physical disability, depression, anxiety, sociodemographic factors, sex differences, Africa, Asia
- MeSH terms
- Africa, Aged, Aged, 80 and over, Aging, Anxiety, Asia, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Quality of Life, Rural Population, Sex Factors, Sleep Wake Disorders, Socioeconomic Factors, World Health Organization, Comorbidity, Prevalence, Internationality
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