Introduction: Previous studies have focused on sleep inequities among disadvantaged populations in high-income countries. However, little is known about the differences in sleep health among adolescents in Africa. We aimed to compare the multi-dimensions of sleep health in adolescents living in rural versus urban communities in Nigeria. Methods: This cross-sectional study enrolled adolescents aged 13-19 in six rural and six urban schools in Osun State, Nigeria. We measured the prevalence of poor sleep quality (Pittsburgh Sleep Quality Index score>5), daytime sleepiness (Epworth Sleepiness Scale for Children and Adolescents score>10), and risk of sleep apnea (Teen STOPBANG). We compared the sleep health variables between the rural and urban populations using multivariable logistic regression. Results: Of the 900 participants (51% rural; 59% female; average age (SD)=15.1(1.4) years), 79% had short sleep duration (<8.5 hours), 14.9% poor sleep quality, 9.6% excessive daytime sleepiness and 9.8% risk of sleep apnea. Urban adolescents had a higher prevalence of poor sleep quality (p=0.004), short sleep duration (p<0.001), daytime sleepiness (p=0.044), and risk of sleep apnea (p=0.006) compared to rural adolescents. The adjusted odds of having poor sleep quality (p=0.008) and daytime sleepiness (p=0.007) were about 2-fold higher among urban compared to rural adolescents. Later school end time, having single/separated parent(s), absence of parental setting of bedtime were independently associated with poorer sleep health. Conclusion: Adolescents in rural communities had better sleep health than adolescents in urban communities. There is a need to develop interventions to improve the sleep quality and overall sleep health of urban-dwelling adolescents.

Oluwatosin Olorunmoteni
Obafemi Awolowo University/ Obafemi Awolowo University Teaching Hospitals Complex
Nigeria

Francesc-Xavier , Gómez-Olivé
University of the Witwatersrand
South Africa

Adesegun Fatusi
University of Medical Sciences
Nigeria

Karine Scheuermaier
University of the Witwatersrand
South Africa