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Insomnia and role impairment in the community

Results from the Nigerian survey of mental health and wellbeing

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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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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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Authors and 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

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  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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