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Insomnia and role impairment in the community

Results from the Nigerian survey of mental health and wellbeing

Social Psychiatry and Psychiatric Epidemiology volume 42, pages 495–501 (2007)Cite this article

Abstract

Background

Estimates of the occurrence of insomnia are not available in sub-Sahara Africa where demographic profile is different from that in developed countries. However, such estimates need to be considered along with associated functional role impairment in assessing the extent of public health burden due to insomnia.

Methods

Face-to-face interviews with a representative sample of persons aged 18 years and over (n = 6,752) in 21 of Nigeria’s 36 states (representing about 57% of the national population) was conducted using the Composite International Diagnostic Interview, version 3. Role impairment, defined as proportion of lost work over the prior month, was assessed using the World Health Organization’s Disability Assessment Schedule.

Results

Insomnia, defined as any sleep complaint lasting at least two weeks in the previous 12-months, was reported by 11.8%, with rates varying between 5.4% for early morning awakening, 7.7% for difficulty initiating sleep, and 8.5% for difficulty maintaining sleep. Increasing age was associated with higher rates of every type of insomnia but females were only more likely than males to report difficulty initiating sleep. Independently, chronic pain conditions, chronic medical conditions, as well as the presence of a DSM-IV mental disorder significantly increased the risk of having insomnia. Multivariate analysis suggests that, even though demographic factors and comorbid physical and mental conditions partly accounted for the association of insomnia with role impairment, a decrement of about 6% of estimated lost work in the prior month was probably attributable to insomnia.

Conclusions

Findings indicate that insomnia is common even in this relatively young population. Its negative effect on role functioning is considerable, is not entirely accounted for by comorbid medical and mental conditions, and may be of public health significance.

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References

  1. Ancoli-Isreal S, Roth T (1999) Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep 22:S347–S353

    Google Scholar 

  2. Anderson HI, Ejlertsson G, Leden I, Schersten B (1999) Impact of chronic pain on health care seeking, self care, and medication. Results from a population based Swedish study. J Epidemiol Commun Health 53:503–509

    Google Scholar 

  3. Bixler EO, Kales A, Soltados CR, Kales JD, Healy S (1979) Prevalence of sleep disorders in the Los Angeles metropolitan area. Am J Psychiatry 136:1257–1262

    PubMed  CAS  Google Scholar 

  4. Blazer DG, Hays JC, Foley DJ (1995) Sleep complaints in older adults: a racial comparison. J Gerontol A Biol Sci Med Sci 50:M280–M284

    PubMed  CAS  Google Scholar 

  5. Breslau N, Roth T, Rosenthal L, Andreski P (1996) Sleep disturbances and psychiatric disorders; a longitudinal epidemiological study of young adults. Biol Psychiatry 39:411–418

    PubMed  Article  CAS  Google Scholar 

  6. Chevalier H, Los F, Boichut D, Bianchi M, Nutt DJ, Hajak G, Hetta J, Hoffmann G, Crowe C (1999) Evaluation of severe insomnia in the general population: results of a European multinational survey. J Psychopharmacol 13:S21–S24.12

    PubMed  CAS  Google Scholar 

  7. Chiu HF, Leung T, Lam LC, et al. (1999) Sleep problems in Chinese Elderly in Hong Kong. Sleep 22:717–72

    PubMed  CAS  Google Scholar 

  8. Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG (1999) Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6800persons over three years. Sleep 22:S366–S372

    PubMed  Google Scholar 

  9. Ford DE, Kamerow DB (1989) Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? J Am Med Assoc 262:1479–1484

    Article  CAS  Google Scholar 

  10. Gureje O, Lasebikan V, Kola L, Makanjuola V (2006) The Nigerian Survey of Mental Health and Wellbeing: Lifetime and 12-month Prevalence of DSM-IV Disorders. Brit J Psychiatry 188:467–471

    Article  Google Scholar 

  11. Gureje O, Obikoya B (1991) Psychotropic drug use in an urban primary care clinic. Soc Psychiatry Psychiatric Epidemiol 26:143–153

    Article  CAS  Google Scholar 

  12. Gureje O, Obikoya B., Ikuesan BA (1992) Prevalence of specific disorders in an urban primary care setting. East Afr Medl J 69:282–287

    CAS  Google Scholar 

  13. Gureje O, Odejide AO, Olatawura MO, Ikuesan BA, Acha RA, Bamidele RW, Raji SO (1995) Results from the Ibadan Centre. In: Ustun TB, Sartorius N (eds) Mental illness in general health care: an international study. John Wiley & Sons, pp 156–173

  14. Hetta J, Broman JE, Mallon L (1999) Evaluation of severe insomnia in the general population-implications for the management of insomnia: insomnia, quality of life and healthcare consumption in Sweden. J Psychopharmacol 13:S35–S36

    PubMed  CAS  Google Scholar 

  15. Hosmer DW, Lemeshow S (2000) Applied logistic regression, 2nd edn. John Wiley & Sons, New York

    Google Scholar 

  16. Karacan I, Thornby JI, William R (1976) Sleep disturbance: a community survey. In a primarily urban Florida county. Soc Sci Med 10:239–244

    PubMed  Article  CAS  Google Scholar 

  17. Kessler RC, Ustun TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13(2):93–121

    PubMed  Article  Google Scholar 

  18. Kim K, Uchiyama M, Okama M, Liu X, Ogiara R (2000) An epidemiological study of insomnia among the Japenese general population. Sleep 23:41–47

    PubMed  CAS  Google Scholar 

  19. Kish L (1995) Survey sampling. New York: John Wiley & Sons

    Google Scholar 

  20. Klink M, Quan SF (1987) Prevalence of reported sleep disturbances in a general adult population and their relationship to obstructive airway diseases. Chest 91:540–546

    PubMed  CAS  Google Scholar 

  21. Leger D, Guilleminault C, Dreyfus JP, Delahaye C, Paillard M (2000) Prevalence of insomnia in a survey of 12,778 adults in France sleep research 9:35–42

    Google Scholar 

  22. Mellinger GD, Balter MB, Uhlenhuth EH (1985) Insomnia and its treatment: prevalence and correlates. Arch Gen Psychiatry 42:225–232

    PubMed  CAS  Google Scholar 

  23. Montgomery DC, Peck EA, Vining GG (2001) Introduction to linear regression analysis. New York, NY, Wiley and Sons

    Google Scholar 

  24. Newman AB, Enright PL, Manolio TA, Haponic EF, Wahl PW (1997) Sleep disturbance, psychosocial correlates and cardiovascular disease in 5201 older adults: the Cardiovascular Health Study. J Am Geriatric Soc 45:1–7 22: 717–772

    CAS  Google Scholar 

  25. Ohayon M (1996) Epidemiological study on insomnia in the General population. Sleep 19:S7–S15

    PubMed  CAS  Google Scholar 

  26. Ohayon MM (1997) Prevalence of DSM-IV diagnostic criteria of insomnia: distinguishing insomnia related to mental disorders from sleep disorders. J Psychiatr Res 31:333–346

    PubMed  Article  CAS  Google Scholar 

  27. Ohayon MM, Caulet M, Guilleminault C (1997) Complaints about nocturnal sleep: how a general population perceives its sleep, and how this relates to the complaints of insomnia. Sleep 20:715–723

    PubMed  CAS  Google Scholar 

  28. Ohayon MM, Caulet M, Priest RG, Guilleminault C (1997) DSM-IV and ICSD-90 insomnia symptoms and sleep dissatisfaction. Br J Psychiatry 171:382–388

    PubMed  CAS  Article  Google Scholar 

  29. Ohayon MM (2000) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 97–111

  30. Ohayon MM, Partinen M (2002) Insomnia and global sleep dissatisfaction in Finland. J sleep Res 11(4):339–346

    PubMed  Article  Google Scholar 

  31. Olson LG (1996) A community survey of insomnia in Newcastle. Aust N Z J Public Health 20:655–657

    PubMed  CAS  Google Scholar 

  32. Quera-Salva MA, Orluc A, Goldenberg F, Guilleminault C (1991) Insomnia and use of hypnotics: study of a French population. Sleep 14:386–391

    PubMed  CAS  Google Scholar 

  33. Rehm J, Ustun TB, Saxena S, Nelson CB, Chatterji S, Ivis F, Adla E (1999) On the development and psychometric testing of the WHO screening instrument to assess disablement in the general population. Int J Method Psychiatric Res 8:110–123.26

    Article  Google Scholar 

  34. Rocha FL, Guerra HL, Lima Costa MF (2002) Prevalence of insomnia and associated socio-demographic factors in a brazilian community: the Bambui study. Sleep Med 3:121–126

    PubMed  Article  Google Scholar 

  35. Roth T, Jaeger S, Jin R, Kalsekar A, Stang P, Kessler R (2006) Sleep problems, comorbid mental disorders, and role functioning in the National Cormorbidity Survey Replication. Biol Psychiatry 60:1364–1371

    PubMed  Article  Google Scholar 

  36. StataCorp Stata Statistical Software, version 7.0 for Windows (2001) Stata, College Station, Texas

  37. Su TP, Huang SR, Chou P (2004) Prevalence and risk factors of insomnia in community dwelling Chinese elderly: a Taiwanese urban area survey. Aust N Z J Psychiatr 38:706–713

    Article  Google Scholar 

  38. The WHO World Mental Health Survey Consortium (2004) Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590

    Article  Google Scholar 

  39. Walsh JK, Engelhardt CL (1999) The direct economic cost of insomnia in the United States for 1995. Sleep 22:386–393

    Google Scholar 

  40. Welstein L, Dement WC, Redington D, Guilleminaut C (1983) Insomnia in the San Francisco Bay area: a telephone survey. In: Guilleminault C, Lugaresi E (eds) Sleep/wake disorders: natural history, epidemiology, and long term evolution. Raven press, New York, pp 29–35

    Google Scholar 

  41. Weyerer S, Diling H (1991) Prevalence and treatment of insomnia in the community: results from upper Bavarian field study. Sleep 14:392–398

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The Nigerian Survey of Mental Health and Well-Being was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. We thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis. These activities were supported by the United States National Institute of Mental Health (R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R01-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/. Additional funding for the Nigerian survey came from the Nigerian Federal Ministry of Health, and support was obtained from the University of Ibadan. Nigerian collaborators were: Oye Gureje (Principal Investigator, University of Ibadan), Richard Uwakwe, (Nnamdi Azikiwe University, Nnewi), Michael Ekpo (Federal Psychiatric Hospital, Calabar), Owoidoho Udofia (University of Calabar), Abba Wakil (Federal Psychiatric Hospital, Maiduguri), Olusola Adeyemi (Psychiatric Hospital, Kaduna) and Nonyenim Enyidah (Rivers Psychiatric Hospital, Port Harcourt). We acknowledge the administrative support provided by Olusola Odujinrin (WHO Country Office, Abuja).

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Affiliations

  1. Dept. of Psychiatry, University of Ibadan, Ibadan, Nigeria

    Oye Gureje, Victor A. Makanjuola & Lola Kola

  2. Dept. of Psychiatry, University College Hospital, Ibadan, Nigeria

    Oye Gureje

Authors
  1. Oye Gureje
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  2. Victor A. Makanjuola
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  3. Lola Kola
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Correspondence to Oye Gureje.

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Gureje, O., Makanjuola, V.A. & Kola, L. Insomnia and role impairment in the community. Soc Psychiat Epidemiol 42, 495–501 (2007). https://doi.org/10.1007/s00127-007-0183-2

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Key words

  • insomnia
  • demographic features
  • role impairment
  • community
  • Nigeria