Ahinkorah Bright Opoku, Aboagye Richard Gyan, Arthur-Holmes Francis, Hagan John Elvis, Okyere Joshua, Budu Eugene, Dowou Robert Kokou, Adu Collins, Seidu Abdul-Aziz
School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.
School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana.
Healthcare (Basel). 2021 Feb 22;9(2):234. doi: 10.3390/healthcare9020234.
(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 -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.
(1) 背景：在影响青少年的健康问题中，焦虑症被视为影响青少年心理健康的有损健康或使人衰弱的后果之一。我们调查了撒哈拉以南非洲（SSA）在校青少年中焦虑引起的睡眠障碍的患病率及相关因素。(2) 方法：本研究对全球学校健康调查（GSHS）的数据进行横断面分析。我们分析了2010年至2017年间来自SSA 11个国家的25454名在校青少年的数据。建立了两个多变量逻辑回归模型，以确定焦虑引起的睡眠障碍与解释变量之间关联的强度。回归分析结果以调整后的优势比（aOR）及其各自的95%置信区间（CI）呈现。统计学显著性设定为p值<0.05。(3) 结果：SSA在校青少年中焦虑引起的睡眠障碍的总体患病率为12.2%。患病率从坦桑尼亚的5.1%到贝宁的20.5%不等。15岁及以上青少年焦虑引起的睡眠障碍的几率高于14岁及以下青少年 [aOR = 1.26，95%CI = 1.15，1.39]。此外，受欺负的青少年 [aOR = 1.54，95%CI = 1.42，1.67]、感到孤独的青少年 [aOR = 3.85，95%CI = 3.52，4.22]、有自杀意念的青少年 [aOR = 1.70，95%CI = 1.52，1.90]、有自杀计划的青少年 [aOR = 1.26，95%CI = 1.13，1.41]、有自杀未遂经历的青少年 [aOR = 1.21，95%CI = 1.08，1.35]、使用大麻的青少年 [aOR = 1.27，95%CI = 1.06，1.52] 和逃学的青少年 [aOR = 1.33，95%CI = 1.22，1.46] 中，焦虑引起的睡眠障碍的几率更高。然而，与女性青少年相比，男性青少年焦虑引起的睡眠障碍的几率较低 [aOR = 0.88，95%CI = 0.81，0.95]。(4) 结论：我们发现SSA在校青少年中焦虑引起的睡眠障碍患病率相对较高。年龄较大、女性、受欺负、孤独、有自杀意念/计划/未遂经历、使用大麻和逃学是焦虑引起的睡眠障碍的危险因素。因此，研究结果凸显了制定针对SSA焦虑引起的睡眠障碍高危在校青少年群体的政策（如早期学校筛查）和干预措施（如理性情绪行为教育（REBE）、社会情感学习（SEL））的紧迫性。
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