Association between physical multimorbidity and sleep problems in 46 low- and middle-income countries

Smith, Lee and Shin, Jae Il and Jacob, Louis and Schuch, Felipe B. and Oh, Hans and Tully, Mark A. and López-Sánchez, Guillermo F. and Veronese, Nicola and Soysal, Pinar and Yang, Lin and Butler, Laurie T. and Barnett, Yvonne A. and Koyanagi, Ai (2022) Association between physical multimorbidity and sleep problems in 46 low- and middle-income countries. Maturitas, 160. pp. 23-31. ISSN 1873-4111

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Official URL: https://doi.org/10.1016/j.maturitas.2022.01.007

Abstract

Background- Little is known about the association between multimorbidity (i.e., two or more chronic conditions) and sleep problems in the general adult populations of low- and middle-income countries (LMICs). Thus, we aimed to assess this association among adults from 46 LMICs, and to quantify the extent to which anxiety, depression, stress, and pain explain this association. Methods- Cross-sectional, predominantly nationally representative, community-based data from the World Health Survey were analyzed. Nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. To be included in the analysis, sleep problems had to have been experienced in the past 30 days and to have been severe or extreme; they included difficulties falling asleep, waking up frequently during the night or waking up too early in the morning. Multivariable logistic regression and mediation analyses were conducted to explore the associations. Results- Data on 237,023 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; 49.2% men] were analyzed. Compared with no chronic conditions, having 1, 2, 3, and ≥4 conditions was associated with 2.39 (95%CI=2.14, 2.66), 4.13 (95%CI=3.62, 4.71), 5.70 (95%CI=4.86, 6.69), and 9.99 (95%CI=8.18, 12.19) times higher odds for sleep problems. Pain (24.0%) explained the largest proportion of the association between multimorbidity and sleep problems, followed by anxiety (21.0%), depression (11.2%), and stress (10.4%). Conclusions- Multimorbidity was associated with a substantially increased odds for sleep problems in adults from 46 LMICs. Future studies should assess whether addressing factors such as pain, anxiety, depression, and stress in people with multimorbidity can lead to improvement in sleep in this population.

Item Type: Journal Article
Keywords: multimorbidity, sleep problems, Low- and middle-income countries, Sleep disorders, Epidemiology
Faculty: Faculty of Health, Education, Medicine & Social Care
Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 19 Jan 2022 11:21
Last Modified: 16 Mar 2022 16:21
URI: https://arro.anglia.ac.uk/id/eprint/707260

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