A Multi-Country Analysis of Prevalence of Anxiety-Induced Sleep Disturbance and Its Associated Factors among In-School Adolescents in Sub-Saharan Africa Using the Global School-Based Health Survey.

Bright Opoku Ahinkorah,John Elvis Hagan,Francis Arthur-Holmes,Richard Gyan Aboagye,Collins Adu,Eugene Budu,Robert Kokou Dowou,Joshua Okyere,Abdul-Aziz Seidu

doi:10.3390/healthcare9020234

Abstract

(1) Background: Among the health problems affecting adolescents, anxiety disorders are considered among the health-compromising or debilitating outcomes that affect adolescents’ mental health. We examined the prevalence and factors associated with anxiety-induced sleep disturbance among in-school adolescents in sub-Saharan Africa (SSA). (2) Methods: This study involved a cross-sectional analysis of data from the Global School-Based Health Survey (GSHS). We analyzed data on 25,454 in-school adolescents from eleven (11) countries in SSA with a dataset between 2010 and 2017. Two multivariable logistic regression models were built to determine the strength of the association between anxiety-induced sleep disturbance and the explanatory variables. The results of the regression analyses were presented using adjusted odds ratios (aOR) and their respective 95% confidence intervals (CIs). Statistical significance was set at p-value < 0.05. (3) Results: The overall prevalence of anxiety-induced sleep disturbance among in-school adolescents in SSA was 12.2%. The prevalence ranged from 5.1% in Tanzania to 20.5% in Benin. The odds of anxiety-induced sleep disturbance was higher among adolescents aged 15 and above [aOR = 1.26, 95% CI = 1.15, 1.39] compared to those aged 14 or younger. Additionally, the odds of anxiety-induced sleep disturbance was higher among adolescents who were bullied [aOR = 1.54, 95% CI = 1.42, 1.67], those that felt lonely [aOR = 3.85, 95% CI = 3.52, 4.22], those who had suicidal ideations [aOR = 1.70, 95% CI = 1.52, 1.90], those who had suicidal plan [aOR = 1.26, 95% CI = 1.13, 1.41], those who have had suicidal attempt [aOR = 1.21, 95% CI = 1.08, 1.35], those who used marijuana [aOR = 1.27, 95% CI = 1.06, 1.52], and those who were truant at school [aOR = 1.33, 95% CI = 1.22, 1.46]. However, male adolescents had lower odds of anxiety-induced sleep disturbance [aOR = 0.88, 95% CI = 0.81, 0.95], compared to their female counterparts. (4) Conclusions: We found a relatively high prevalence of anxiety-induced sleep disturbance among in-school adolescents in SSA. Higher age, being female, being bullied, loneliness, having suicidal ideations/plan/attempt, use of marijuana and truancy were risk factors for anxiety-induced sleep disturbance. The findings, therefore, highlight the urgency for policies (e.g., early school-based screening) and interventions (e.g., Rational Emotive Behavioral Education (REBE), Social Emotional Learning (SEL) that target in-school adolescents within the most at-risk populations of anxiety-induced sleep disturbance in SSA.

Highlights

According to scholars, anxiety disorders are a set of mental health conditions that are characterized by emotional or social loneliness, worry, sleep disturbance, and excessive fear [1,2,3,4]
The finding is supported by Dashiff et al [23], and Osborn, Campbell, Weisz and Ndetei [24] who posit that anxiety disorders are likely to be elevated in sub-Saharan Africa (SSA) and other low- and middle-income countries (LMICs), compared to high-income countries like Mexico where anxiety disorders have been reported to be low [25]
The study extends what is known about the prevalence and predictors of anxietyinduced sleep disturbance among in-school adolescents in SSA

Summary

Introduction

Anxiety disorders are a set of mental health conditions that are characterized by emotional or social loneliness, worry, sleep disturbance, and excessive fear [1,2,3,4]. Among the health problems affecting adolescents, anxiety-induced sleep disturbance is considered as one that affects their mental health. Empirical findings show that “mental health conditions account for 16% of the global burden of disease and injury in people aged. Kessler et al [9] indicated that about 10–20% of adolescents worldwide experience mental health conditions and half of all mental health issues begin at the age of 14 years. Anxiety disorders among adolescents have been defined and differentiated through various forms: generalized anxiety disorder, separation anxiety disorder, panic disorder, social phobia, and specific phobia [3,12]

Methods

Discussion

Conclusion