Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia.
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia.
Sleep Health. 2019 Aug;5(4):335-343. doi: 10.1016/j.sleh.2019.06.002. Epub 2019 Jul 16.
Worldwide, 68.5 million individuals are refugees, asylum seekers, or internally displaced. Although many studies have examined mental health concerns in this population, few studies have assessed sleep or examined the relationship between sleep and mental health or psychosocial functioning.
The objectives were to (1) examine the prevalence of sleep disturbance within refugees and asylum seekers from diverse backgrounds, (2) examine mental health and psychosocial factors associated with sleep disturbance, and (3) explore whether symptoms cluster together in unique subsets of individuals.
Clinician-administered interview data (N = 2703) were obtained from a large mental health service in greater Melbourne, Australia. Data included patient demographics, sleep disturbance, mental health (anxiety, depression, traumatic stress symptoms), and psychosocial concerns (family dysfunctions, interpersonal difficulties, social isolation).
A total of 75.5% of the sample reported moderate or severe sleep disturbance. Severity of sleep disturbance was positively correlated with severity of mental health symptoms, psychosocial concerns, age, and migration status. This was true in both refugee and asylum seeker populations and in both adults and children. Cluster analyses revealed 3 subsets of individuals: those with "severe sleep and anxiety symptoms," "mild to moderate symptoms," and "mild symptoms." Using "mild symptoms" as the comparator, being a refugee and increasing age were associated with a 1.57- and 1.02-fold increase, respectively, in the likelihood of classification as "severe sleep and anxiety problems" and 1.70- and 1.02-fold increase, respectively, in the likelihood of classification as "mild to moderate symptoms."
These findings suggest that systematic screening of sleep disturbance among refugees and asylum seekers during health-related visits is needed.
全球有 6850 万人是难民、寻求庇护者或国内流离失所者。尽管许多研究都调查了这一人群的心理健康问题，但很少有研究评估睡眠，也很少研究睡眠与心理健康或心理社会功能之间的关系。
本研究的目的是：(1) 调查来自不同背景的难民和寻求庇护者中睡眠障碍的发生率；(2) 调查与睡眠障碍相关的心理健康和心理社会因素；(3) 探索症状是否在个体的独特亚组中聚集。
从澳大利亚墨尔本地区的一家大型心理健康服务机构获得了临床医生管理的访谈数据（N=2703）。数据包括患者人口统计学信息、睡眠障碍、心理健康（焦虑、抑郁、创伤后应激症状）和心理社会问题（家庭功能障碍、人际关系困难、社会孤立）。
样本中共有 75.5%的人报告存在中度或重度睡眠障碍。睡眠障碍的严重程度与心理健康症状、心理社会问题的严重程度、年龄和移民身份呈正相关。这一结果在难民和寻求庇护者群体以及成人和儿童中均成立。聚类分析显示存在 3 种个体亚组：“严重睡眠和焦虑症状”、“轻度至中度症状”和“轻度症状”。与“轻度症状”相比，被认定为“严重睡眠和焦虑问题”的可能性分别增加 1.57 倍和 1.02 倍，被认定为“轻度至中度症状”的可能性分别增加 1.70 倍和 1.02 倍。
这些发现表明，在与健康相关的就诊过程中，需要对难民和寻求庇护者的睡眠障碍进行系统筛查。
