Prevalence and Predictors of Poor Sleep Quality Among Adolescents in Central Sudan: The Role of Depression, Anxiety, and Gender

Background: Sleep is crucial for adolescent health; however, there is a scarcity of data on adolescent sleep in Sudan, which has a major sociopolitical disruption. Thus, this study aimed to determine the prevalence of poor sleep quality and the factors associated with it among adolescents who returned after internal displacement in Central Sudan. Methods: A multi-stage, stratified random sampling approach was used in a community-based, cross-sectional study conducted in East Gezira, Central Sudan. Data from 365 adolescents were collected on sociodemographic factors, body mass index (BMI), and mental health. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The Patient Health Questionnaire (PHQ)-9 was used to measure symptoms of depression, and anxiety symptoms were measured using the Generalized Anxiety Disorder (GAD-7) questionnaire. Multivariate binary logistic regression was performed to identify factors associated with poor sleep quality, defined as a PSQI score > 5. Results: , respectively. The median (IQR) depression and anxiety scores were 2 (0‒4) and 2 (1‒5), respectively. Thirty-five (9.6%) of the 365 adolescents had poor sleep quality. A multivariate binary analysis showed that poor sleep quality was positively associated with depression scores (adjusted odds ratio [AOR] =1.20; 95% confidence interval [CI] = 1.04‒1.37) and anxiety scores (AOR = 1.20; 95% CI = 1.05‒1.38). Female adolescents were found to be at higher risk of poor sleep quality than males (AOR = 3.94; 95% CI = 1.18‒13.07). Conclusion: This study indicates that the prevalence of poor sleep quality (9.6%) among adolescents in Central Sudan is lower than reported in the existing literature. Poor sleep quality is significantly associated with mental health conditions, particularly depression and anxiety, as well as being female. These results highlight the need for mental health support to improve adolescent sleep health in the region.