Self-Reported Sleep Duration and Its Correlates with Sociodemographics, Health Behaviours, Poor Mental Health, and Chronic Conditions in Rural Persons 40 Years and Older in South Africa

Abstract

This study aims to investigate sleep duration and its association with sociodemographic, health behaviour, mental health, and chronic disease factors among rural individuals 40 years and older in South Africa. Cross-sectional data from the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa” (HAALSI) baseline survey were analysed. Socio-demographic, clinical, health, and sleep duration data were collected. The total sample included 4725 persons 40 years and older (mean age 61.5 years, SD = 13.0, age range of 40–111 years) in one sub-district in rural South Africa. The mean sleep duration was 8.28 ± 1.93 h. Short (<7 h) and long (≥9 h) sleepers accounted for 13.1% and 40.0% of the sample, respectively. In adjusted multinomial logistic regression, greater wealth status (p < 0.05), inadequate fruit and vegetable consumption (p < 0.001), and depressive symptoms (p < 0.05) were associated with a higher odds and physical inactivity (p < 0.05) with a lower odds of short sleep duration. Being male (p < 0.001) and depressive symptoms (p < 0.001) were associated with a higher odds and being 50 to 69 years old (p < 0.01), having Grade 1 to 11 education (p < 0.05), and greater wealth status (p < 0.001) were associated with a lower odds of long sleep duration. In adjusted multinomial logistic regression, compared to normal sleepers, long sleepers were more likely to have myocardial infarction (p < 0.05). In unadjusted analysis, compared to normal sleepers, short sleepers were more likely to have cataracts (p < 0.05). This study found that a significant proportion of rural dwellers 40 years and older in South Africa had a short sleep duration and a high proportion had a long sleep duration. Some associations, such as depression and myocardial infarction, with short and/or long sleep duration were confirmed, while no associations were found for many chronic conditions.

Effect of Inadequate Sleep on Frequent Mental Distress

“…Previous research has not closely examined the association between inadequate sleep as a risk factor for frequent mental distress. However, inadequate sleep has been linked to poor biological measures, including hypertension, anemia, and dyslipidemia ( 7 ). Low amounts of sleep and the attributed chronic conditions could possibly have a negative impact on depressive symptoms ( 7 ).…”

“…The Centers for Disease Control and Prevention (CDC) and the American Academy of Sleep Medicine emphasize the importance of an adequate night's sleep, which is defined as 7 or more hours per night with no upper limit (5,6). Anything less than this amount may lead to the development of various chronic diseases.…”

“…More than one-third of the US population does not get adequate sleep (5). The people that most often get inadequate sleep are Native Hawaiian/Pacific Islander people, non-Hispanic Black people, and multiracial people (6). Those who most often get adequate sleep are married people and people with a college degree or more.…”

“…Studies have demonstrated an association between inadequate sleep and frequent mental distress ( 7 , 8 ), and sleep deprivation causes substantial negative health outcomes ( 4 ). The link between inadequate sleep and frequent mental distress has been viewed historically as a symptom–disease association with sleep inadequacies deriving from preexisting mental distress ( 9 ).…”

Socioeconomic Position and Excessive Daytime Sleepiness

“…Alteration in sleep has been linked to a wide range of health issues including cardiovascular or metabolic disorders [6][7][8][9][10][11][12], as well as an increase in workplace and occupational health issues due to sleep disturbances such as excessive daytime sleepiness (EDS) [13][14][15].…”