Prevalence and associated factors of sleep quality in a middle eastern country undergoing an economic - Political unrest and war conflicts.

OBJECTIVES: This study aimed to quantify the prevalence of poor sleep quality and its associated factors among the general population in Lebanon, a middle-eastern country witnessing economic-political instability and a rise in the prevalence of mental health disorders. METHODS: An online cross-sectional survey study targeting Lebanese residents 18 to 80 years old. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), depression the Patient Health Questionnaire (PHQ-9), and anxiety the Generalized Anxiety Disorder Scale (GAD-7). PSQI as an outcome variable compared poor to good sleep quality. RESULTS: Data was collected from 582 participants with a mean age of 34.5 ± 14.9 years, and 63.8% females. According to the PSQI, the prevalence of poor sleep quality was estimated to be 63.6%. Binary logistic regression analysis indicated that moderate (OR = 4.69, CI = 2.33-9.41) to severe anxiety (OR = 8.75, CI = 3.44-22.26), moderate (OR = 3.56, CI = 1.60-7.97) to severe depression (OR = 3.13, CI = 1.26-7.76), diabetes (OR = 3.18, CI = 1.14-8.91) and sleep apnea (OR = 3.13, CI = 1.07-9.18) were significantly associated with a higher odds of poor sleep quality. Sociodemographic, lifestyle factors and other co-morbidities were no more significantly associated with poor sleep after adjustment in the multivariate regression analysis. CONCLUSIONS: There is a high prevalence of poor sleep quality among our sampled population in Lebanon, and a strong correlation with poor mental health, namely symptoms of anxiety and depression. These findings may warrant strategic interventions for patient care, such as routine sleep quality screening for individuals suffering from mental health disorders as well as chronic diseases namely diabetes, in high-stress communities.