Wafula Solomon T, Namakula Lydia N, Isunju John B, Mugambe Richard K, Ssekamatte Tonny, Musoke David, Wanyenze Rhoda K
Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda.
Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
PLoS One. 2025 Jan 3;20(1):e0312127. doi: 10.1371/journal.pone.0312127. eCollection 2025.
Psychoactive substance use in adults and second-hand smoke (SHS) exposure among children are leading contributors to sleeping problems. Despite this, there is limited data on how these exposures influence sleep patterns in informal settings. Our study assessed the associations between substance use, SHS exposure and sleep disturbances among adults and children in an urban informal settlement in Uganda.
We conducted a cross-sectional study in an urban informal settlement in Kampala, Uganda. Data was collected on self-reported sleep problems among adults including sleep duration, insomnia and sleep dissatisfaction, as well, as sleep-disordered breathing (SDB) in children. We evaluated children's early-life SHS exposure and psychoactive substance use in adults using questionnaires. We modelled the associations between the exposures and sleep problems in adults and children using modified Poisson regression.
Data were collected from 284 adults, who also reported on their children's sleep experience. Among adults, 59.2% reported insufficient sleep (less than 7 hours), 34.9% experienced insomnia, and 28.3% were dissatisfied with their sleep patterns. Active smoking was associated with insomnia (Prevalence Ratio (PR) = 2.74, 95% Confidence Interval (CI): 1.14-6.59), and alcohol use was associated with sleep dissatisfaction (PR = 1.81, 95% CI 1.23-2.69). In children, 40.0% (88/220) exhibited SDB problems. Those exposed to SHS either during pregnancy or within six months post-birth had a higher risk of SDB than unexposed children (PR = 1.78, 95% CI 1.21-2.61). The risk was also elevated for children exposed to SHS during both periods (PR = 1.48, 95% CI 1.02-2.13).
Our findings suggest that smoking was associated with insomnia and alcohol with sleep dissatisfaction among adults. Early-life SHS exposure was associated with an increased risk of SDB in children. These results emphasize the need to support ongoing public health initiatives and maintain a smoke-free environment, particularly for children in their early life.
成年人使用精神活性物质以及儿童接触二手烟（SHS）是导致睡眠问题的主要因素。尽管如此，关于这些接触在非正式环境中如何影响睡眠模式的数据有限。我们的研究评估了乌干达一个城市非正式定居点中成年人和儿童的物质使用、SHS接触与睡眠障碍之间的关联。
我们在乌干达坎帕拉的一个城市非正式定居点进行了一项横断面研究。收集了关于成年人自我报告的睡眠问题的数据，包括睡眠时间、失眠和睡眠不满，以及儿童的睡眠呼吸障碍（SDB）。我们使用问卷评估了儿童早期的SHS接触情况和成年人的精神活性物质使用情况。我们使用修正的泊松回归模型来模拟这些接触与成年人和儿童睡眠问题之间的关联。
收集了284名成年人的数据，他们还报告了其子女的睡眠经历。在成年人中，59.2%报告睡眠不足（少于7小时），34.9%经历过失眠，28.3%对自己的睡眠模式不满意。主动吸烟与失眠相关（患病率比值（PR）=2.74，95%置信区间（CI）：1.14 - 6.59），饮酒与睡眠不满相关（PR = 1.81，95% CI 1.23 - 2.69）。在儿童中，40.0%（88/220）表现出SDB问题。在孕期或出生后六个月内接触SHS的儿童比未接触的儿童患SDB的风险更高（PR = 1.78，95% CI 1.21 - 2.61）。在这两个时期都接触SHS的儿童风险也有所升高（PR = 1.48，95% CI 1.02 - 2.13）。
我们的研究结果表明，吸烟与成年人的失眠相关，饮酒与成年人的睡眠不满相关。儿童早期接触SHS与患SDB的风险增加相关。这些结果强调了支持正在进行的公共卫生倡议并维持无烟环境的必要性，特别是对于幼儿。
