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Insomnia Symptoms and Their Association with Anxiety and Poor Sleep Hygiene Practices Among Ethiopian University Students

Authors Manzar MD, Noohu MM, Salahuddin M, Nureye D, Albougami A, Spence DW, Pandi-Perumal SR, Bahammam AS

Received 22 January 2020

Accepted for publication 15 July 2020

Published 13 August 2020 Volume 2020:12 Pages 575—582


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Steven A Shea

Md Dilshad Manzar,1 Majumi M Noohu,2 Mohammed Salahuddin,3,4 Dejen Nureye,3 Abdulrhman Albougami,1 David Warren Spence,5 Seithikurippu R Pandi-Perumal,6 Ahmed S Bahammam7,8

1Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia; 2Centre for Physiotherapy and Rehabilitation Sciences, Jamia Milia Islamia, New Delhi, India; 3Mizan-Tepi University, Mizan-Aman, Ethiopia; 4Department of Bio-Molecular Sciences, Pharmacology Division, University of Mississippi, Oxford, MS, USA; 5Independent Researcher, Toronto, ON, Canada; 6Somnogen Canada Inc, Toronto, ON, Canada; 7The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 8The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in Saudi Arabia (MED511-02-08), Riyadh, Saudi Arabia

Correspondence: Md Dilshad Manzar Department of Nursing, College of Applied Medical Sciences
Majmaah University, Al Majmaah 11952, Saudi Arabia

Objective: There is a paucity of research evidence available regarding the impact of anxiety and sleep hygiene on insomnia and related sleep complaints among collegiate students in lower-income countries. The purpose of this study was to investigate if insomnia and insomnia-related sleep complaints are associated with anxiety, age, and sleep hygiene practices among a sample of university students in Ethiopia.
Design, Measures, Setting, and Participants: The participants were young adults (n=525; mean age 21.5 ± 3.0 years; mean BMI of 20.7 ± 2.7kg/m2). Young collegiate adults at Mizan-Tepi University in southwestern Ethiopia were randomly selected to participate in this cross-sectional study. The measures included the Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), the Generalized Anxiety Disorder– 7 Scale (GAD-7), and the Sleep Hygiene Index (SHI). Descriptive statistics, binary logistic regression, and multiple linear regressions were used.
Results: Insomnia was associated with young age group (≤ 25 years) (odds ratio (OR) = 2.20, 95% confidence interval (CI) 1.04– 4.66), higher GAD-7 (anxiety) (OR = 1.05, 95% CI 1.0– 1.10) and SHI (poor sleep hygiene) (OR = 1.15, 95% CI 1.05– 1.26) scores. All four insomnia-related sleep complaints were associated with increasing GAD-7 scores, as well as higher SHI scores (p< 0.001).
Conclusion: Insomnia was associated with younger age group (≤ 25 years), higher anxiety level, and poor sleep hygiene. Four major sleep complaints in insomnia, ie, sleep onset problems, poor sleep quality, awakening problems, and daytime disturbances, were all associated with higher anxiety levels and poor sleep hygiene.

Keywords: sleep, sleepiness, daytime dysfunction, young adults, low-income country

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