Sleep health in the context of energy insecurity: A mixed-methods study of load shedding in South Africa

OBJECTIVE: To examine how load shedding (scheduled power outages) affects multiple dimensions of sleep health, associated behaviors, and lived experiences among South African adults. METHODS: This study used a convergent mixed-method cross-sectional design. Data were collected through an online survey, that included demographic questions, the RU SATED questionnaire, structured items evaluating sleep-related behavioral changes, and an open-ended question for qualitative insights. A total of 173 participants experiencing load shedding in South Africa completed the survey between May and August of 2023. Quantitative analyses comprised nonparametric tests and multiple linear regression, whereas qualitative responses were subjected to thematic analysis. Data integration was achieved through joint display and thematic triangulation. RESULTS: Overall sleep health scores significantly declined with increasing load shedding severity (p = .023), particularly affecting sleep satisfaction (p < .001) and duration (p = .002). Participants exposed to stage six load shedding demonstrated significantly poorer sleep health scores compared to those exposed to lower stages (p < .001). Two themes were developed through qualitative analysis: (1) disruption of sleep quality due to environmental disturbances (noise, light, and temperature), and (2) emotional and psychological stress (anxiety, and safety concerns). Structured survey items further indicated disruptions to sleep continuity, regularity and duration. CONCLUSION: In this study, load shedding affected multiple dimensions of sleep health through environmental disruption, psychological strain, and adaptive behavioral responses. These preliminary findings highlight the need for replication in diverse populations using objective measures and suggest that integrating sleep health considerations into energy policy may be warranted.