Prevalence of Sleep Disturbances in Latin American Populations and Its Association with Their Socioeconomic Status—A Systematic Review and a Meta-Analysis

Abstract

Background: The worldwide increase in the prevalence and incidence of sleep disturbances represents a major public health issue. Among multiple determinants affecting sleep health, an individual’s socioeconomic status (SES) is the most ignored and underestimated throughout the literature. No systematic review on the relation between SES and sleep health has been previously conducted in Latin America. Methods: PRISMA guidelines were used. Results: Twenty articles were included in the final sample (all cross-sectional studies), and twelve among them were rated as fair or poor quality. Among these studies, 80.0% (n = 16) were performed in Brazil, 10.0% (n = 2) were performed in Peru, 5.0% (n = 1) were performed in Chile, and 5.0% (n = 1) were multicentric (11 countries). The combined total number of participants was N = 128.455, comprising 3.7% (n = 4693) children, 16.0% (n = 20,586) adolescents, and 80.3% (n = 103,176) adults. The results show the following: (1) The sleep outcomes analyzed were sleep duration, sleep quality/sleep disturbance, insomnia, excessive daytime sleepiness (EDS), obstructive sleep apnea (OSA)/sleep-disordered breathing (SDB) symptoms, and bruxism. (2) The most used determinants were income, education level, employment status/occupation, wealth/assets, and composite indices. (3) Higher SES was associated with shorter sleep duration. (4) Lower SES was associated with a decrease in sleep quality, less frequent snoring, more prevalent EDS, and sleep bruxism. (5) Lower education was associated with insomnia. (6) Higher education was associated with more sleep bruxism. (7) The pooled prevalence using a meta-analysis of the random effects model was 24.73% (95%CI, 19.98–30.19), with high heterogeneity (I2 = 100%). (8) The prevalence of sleep disturbances decreased with high education (OR, 0.83; 95%CI, [0.69–0.99]; I2 = 79%), while it increased with low income (OR, 1.26; 95%CI, [1.12–1.42]; I2 = 59%), unemployment (OR, 2.84; 95%CI, [2.14–3.76]; I2 = 0%), and being a housewife (OR, 1.72; 95%CI, [1.19–2.48]; I2 = 55%). Discussion: This meta-analysis shows that lower SES (education, income, and work) was associated with sleep disturbances in Latin America. Therefore, sleep disturbance management should be addressed with a multidimensional approach, and a significant investment in targeted public health programs to reduce sleep disparities and support research should be made by the government before the situation becomes uncontrollable.

Mapping of the network connection between sleep quality symptoms, depression, generalized anxiety, and burnout in the general population of Peru and El Salvador

“…This is even more important, considering the high prevalence of sleep-related symptoms in Latin America (Bouscoulet et al 2008 ). In this regard, a meta-analysis showed that in Latin America, individuals belonging to a lower socioeconomic level (characterized by low-quality education, lower income, and poor quality work) were more likely to suffer from sleep disorders (Etindele Sosso et al, 2023 ). Recent studies conducted in Peru and El Salvador reported that depression was positively related to insomnia and anxiety (Baños-Chaparro, 2023 ; Mena & Calderón, 2022 ), demonstrating a close relationship between symptoms of sleep disorders, depressive disorders, and generalized anxiety disorders in the Latin American region.…”