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Jacob L, Smith L, Kostev K, Oh H, Gyasi RM, López Sánchez GF, Song TJ, Tully MA, Haro JM, Yon DK, Shin JI, Koyanagi A. Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries. J Sleep Res 2023:e13852. [PMID: 36808652 DOI: 10.1111/jsr.13852] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007-2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged ≥18 years were analysed (mean [standard deviation] age 43.8 [14.4] years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio = 1.53, 95% confidence interval = 1.11-2.10) and severe food insecurity (odds ratio = 2.35, 95% confidence interval = 1.56-3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage = 43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University, Seoul, South Korea
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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Ngarka L, Siewe Fodjo JN, Aly E, Masocha W, Njamnshi AK. The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa. Front Immunol 2022; 12:803475. [PMID: 35095888 PMCID: PMC8792387 DOI: 10.3389/fimmu.2021.803475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/13/2021] [Indexed: 12/31/2022] Open
Abstract
Neurological disorders related to neuroinfections are highly prevalent in Sub-Saharan Africa (SSA), constituting a major cause of disability and economic burden for patients and society. These include epilepsy, dementia, motor neuron diseases, headache disorders, sleep disorders, and peripheral neuropathy. The highest prevalence of human immunodeficiency virus (HIV) is in SSA. Consequently, there is a high prevalence of neurological disorders associated with HIV infection such as HIV-associated neurocognitive disorders, motor disorders, chronic headaches, and peripheral neuropathy in the region. The pathogenesis of these neurological disorders involves the direct role of the virus, some antiretroviral treatments, and the dysregulated immune system. Furthermore, the high prevalence of epilepsy in SSA (mainly due to perinatal causes) is exacerbated by infections such as toxoplasmosis, neurocysticercosis, onchocerciasis, malaria, bacterial meningitis, tuberculosis, and the immune reactions they elicit. Sleep disorders are another common problem in the region and have been associated with infectious diseases such as human African trypanosomiasis and HIV and involve the activation of the immune system. While most headache disorders are due to benign primary headaches, some secondary headaches are caused by infections (meningitis, encephalitis, brain abscess). HIV and neurosyphilis, both common in SSA, can trigger long-standing immune activation in the central nervous system (CNS) potentially resulting in dementia. Despite the progress achieved in preventing diseases from the poliovirus and retroviruses, these microbes may cause motor neuron diseases in SSA. The immune mechanisms involved in these neurological disorders include increased cytokine levels, immune cells infiltration into the CNS, and autoantibodies. This review focuses on the major neurological disorders relevant to Africa and neuroinfections highly prevalent in SSA, describes the interplay between neuroinfections, immune system, neuroinflammation, and neurological disorders, and how understanding this can be exploited for the development of novel diagnostics and therapeutics for improved patient care.
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Affiliation(s)
- Leonard Ngarka
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
- Neuroscience Lab, Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Joseph Nelson Siewe Fodjo
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
- Global Health Institute, University of Antwerp, Antwerp, Belgium
| | - Esraa Aly
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Safat, Kuwait
| | - Willias Masocha
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Safat, Kuwait
| | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
- Neuroscience Lab, Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
- Department of Neurology, Yaoundé Central Hospital, Yaoundé, Cameroon
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Lawry LL, Stroupe Kannappan N, Canteli C, Clemmer W. Mixed-methods assessment of health and mental health characteristics and barriers to healthcare for Ebola survivors in Beni, Butembo and Katwa health zones of the Democratic Republic of Congo. BMJ Open 2021; 11:e050349. [PMID: 34380729 PMCID: PMC8359460 DOI: 10.1136/bmjopen-2021-050349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/23/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Health and mental health characteristics of all respondents, barriers to accessing health and mental health services and the characteristics and those most at risk for mental health disorders. SETTING Beni, Butembo and Katwa health zones in the Democratic Republic of Congo. PARTICIPANTS The sample contained 223 Ebola survivors, 102 sexual partners and 74 comparison respondents living in the same areas of the survivors. Survivors were eligible if aged >18 years with confirmed Ebola-free status. The comparison group was neither a survivor nor a partner of a survivor and did not have any household members who contracted Ebola virus disease (EVD). PRIMARY AND SECONDARY OUTCOME MEASURES Health and mental health characteristics, barriers to care and the association of association of mental health disorders with study population characteristics. RESULTS Funding was a barrier to accessing needed health services among all groups. Nearly one-third (28.4%, 95% CI 18.0% to 38.7%) of comparison households avoided getting injections for their children. Although most pregnant women were attending antenatal care, less than 40% of respondents stated EVD precautions were discussed at those visits. Trouble sleeping and anger were the strongest predictors of post-traumatic stress disorder, major depressive disorder (MDD), anxiety and suicide attempts with 3-fold to 16-fold increases in the odds of these disorders. There was a 71% decrease in the odds of MDD if current substance abuse (aOR 0.29; 95% CI 0.13 to 0.67; p<0.01) was reported. CONCLUSIONS Specialised mental health services were limited. Fear of contracting EVD influenced vaccine compliance. Anger and sleep disorders significantly increased the odds of mental health disorders across all groups. Respondents may be using substance abuse as self-medication for MDD. Ebola outbreak areas would benefit from improved screening of mental health disorders and associated conditions like anger and sleep difficulties and improved mental health services that include substance abuse prevention and treatment.
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Affiliation(s)
- Lynn Lieberman Lawry
- Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences F Edward Hébert School of Medicine, Bethesda, Maryland, USA
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Naville R, Subtil F, Sy M, Marquis M, Costes P, Letrilliart L. Scope of health problems managed by general practitioners in Mali and France: awaiting practice transition in sub-Saharan Africa? Fam Pract 2020; 37:668-674. [PMID: 32531028 DOI: 10.1093/fampra/cmaa035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Minimal data are available on the clinical activity of general practitioners (GPs) in Africa. OBJECTIVE To describe the health problems managed by GPs in Mali as compared with France where epidemiological transition is already advanced. METHODS A retrospective, multicenter study, conducted in five Malian Community Health Centers. We compared their consultation data to those of the ECOGEN (Eléments de la COnsultation en médecine GENérale) study conducted in 128 French general practices, after data standardization for age and sex. RESULTS Malian and French databases included 19 068 and 19 341 consultations, respectively. Patients had an average of 1.2 health problems managed per consultation in Mali, versus 2.2 in France. They were dominated by infections (51.3%) in Mali, including malaria (24.9%), pneumonia (9.0%) and gastrointestinal infections (5.0%). In comparison with French GPs, Malian GPs more frequently managed cardiovascular (20.2% versus 13.5%), respiratory (15.0% versus 12.4%) and digestive (13.3% versus 7.8%) problems, and less frequently musculoskeletal (3.1% versus 12.6%), endocrine/metabolic (1.5% versus 10.7%) and psychological (0.2% versus 8.2%) problems. The main activity performed by French GPs was prevention (11.0%), which was nominal in Mali. Apart from hypertension, which accounted for 18.9% of the health problems managed in Mali, chronic conditions were less often managed by Malian GPs than by French GPs (12.3% versus 39.6%). CONCLUSIONS Africa is currently at the crossroads where chronic conditions carried with the epidemiological transition are progressing, while the burden of communicable diseases is still overwhelming. Along with the enhancing medicalization of primary care in Mali, the transition of practices is just emerging.
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Affiliation(s)
- Raphaël Naville
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Univ. Lyon, Lyon, France
| | - Fabien Subtil
- Service de Biostatistique-Bioinformatique, Hospices Civils de Lyon, Lyon, France
| | | | - Michel Marquis
- Agence régionale de santé Auvergne-Rhône-Alpes, Direction de la Santé Publique, Lyon, France
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Peltzer K, Pengpid S. Prevalence, and social and health correlates of insomnia among persons 15 years and older in South Africa. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1177/0081246318818623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study aims to investigate the prevalence, and social and health correlates of insomnia symptoms in a national population sample in South Africa. Data were analysed from the cross-sectional ‘South African National Health and Nutrition Examination Survey (SANHANES-1)’ 2012, using a sample of 15,133 individuals (mean age = 36.9, SD = 16.5). Measures included information on insomnia, sociodemographics, health status, health risk behaviour, and mental health. Results indicate that the overall prevalence of insomnia symptoms was 7.1%, with 3.5% among 15- to 24-year-olds and 20.5% among 65 years and older participants. In the adjusted logistic regression analysis, poorer health status (self-rated health, functional disability and cognitive impairment), having bodily pain, having experienced three or more traumatic events, and having psychological distress and partial Posttraumatic Stress Disorder were positively associated with insomnia. A significant proportion of South Africans have insomnia symptoms and several risk factors were identified that can help in guiding interventions.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS, STIs and TB (HAST), Human Sciences Research Council, Pretoria, South Africa
- Department of Research Innovation and Development, University of Limpopo, Sovenga, South Africa
| | - Supa Pengpid
- Department of Research Innovation and Development, University of Limpopo, Sovenga, South Africa
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
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Senbanjo IO, Salisu MA, Oshikoya KA, Adediji UO, Akinola AO. Nigerian sleep study found that children slept less and had more problems than children in other countries. Acta Paediatr 2018. [PMID: 29527732 DOI: 10.1111/apa.14313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM We studied sleep patterns, sleep problems and associated socio-demographic factors among children aged one year to 12 years in Lagos, Nigeria. METHODS This prospective hospital-based study involved 432 children (55% males) who came for routine paediatric care at the Lagos State University Teaching Hospital. Information on socio-demographics, sleeping patterns and specific sleep disorders was obtained. RESULTS The mean age of the subjects was 5.4 ± 3.3 years. Night sleep duration decreased significantly with age from 9.6 ± 1.3 hours at one to four years to 8.7 ± 1.0 hours at nine years to 12 years (p < 0.001). There was no significant gender difference in bedtimes (p = 0.057), rise times (p = 0.095) and night sleep duration (p = 0.191). Most (70%) napped during the day, and 26% of these did so on a regular basis. The most common sleep problems were enuresis (42%), afraid of sleeping alone (38%), snoring (28%) and sleep talking (24%). There was no significant association between sleep duration (p > 0.05), sleep problems (p > 0.05) and socio-demographic characteristics. Comparisons with other studies showed that the children had shorter sleep duration than peers in other countries and regions and a higher prevalence of sleep disorders. CONCLUSION Children in Nigeria had shorter sleep duration and more sleep problems than children in other international studies.
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Affiliation(s)
- Idowu O. Senbanjo
- Department of Paediatrics and Child Health; Lagos State University College of Medicine; Ikeja Lagos Nigeria
| | - Mohammed A. Salisu
- Department of Paediatrics and Child Health; Lagos State University College of Medicine; Ikeja Lagos Nigeria
| | - Kazeem A. Oshikoya
- Department of Pharmacology and Therapeutics; Lagos State University College of Medicine; Ikeja Lagos Nigeria
| | - Uchechukwu O. Adediji
- Department of Paediatrics and Child Health; Lagos State University Teaching Hospital, GRA; Ikeja Lagos Nigeria
| | - Ayodeji O. Akinola
- Department of Paediatrics and Child Health; Lagos State University Teaching Hospital, GRA; Ikeja Lagos Nigeria
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Pengpid S, Peltzer K. Prevalence and social and health correlates of insomnia symptoms among middle- and older-age persons in rural South Africa. JOURNAL OF PSYCHOLOGY IN AFRICA 2018; 28:472-478. [PMID: 34671191 DOI: 10.1080/14330237.2018.1539897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study investigated the prevalence and social and health correlates of insomnia symptoms among middle- and older-adults in rural South Africa. We analysed baseline survey data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI) (N = 5 059; females = 53.6%; largely African Shangaan/Tsonga-speaking). In all, 8.0% of the adults had three insomnia symptoms, 8.9% of participants had difficulty initiating sleep, 13.6% had difficulty in sleep maintenance, and 6.5% had poor sleep quality. In adjusted logistic regression, lower education, perceived unsafe neighbourhood, poorer self-rated health status, vision difficulty, pain, depressive symptoms, and posttraumatic stress disorder (PTSD) symptoms increased the odds of having insomnia symptoms. Insomnia symptoms are common in middle- and older-age adults in rural South Africa, and various risk factors were identified. This can help in improving insomnia prevention treatment in this population.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.,Department of Research & Innovation, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Research & Innovation, University of Limpopo, Turfloop, South Africa.,HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria, South Africa
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Whitesell PL, Obi J, Tamanna NS, Sumner AE. A Review of the Literature Regarding Sleep and Cardiometabolic Disease in African Descent Populations. Front Endocrinol (Lausanne) 2018; 9:140. [PMID: 29695999 PMCID: PMC5904363 DOI: 10.3389/fendo.2018.00140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/16/2018] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED In the twenty-first century, African descent populations on both the continent of Africa and throughout the world are experiencing a high rate of both sleep disturbances and cardiometabolic diseases. The most common sleep disturbances are reduced sleep duration, insomnia, disordered circadian rhythm, and obstructive sleep apnea. Cardiometabolic diseases include hypertension, coronary artery disease, diabetes, hyperlipidemia, and the metabolic syndrome. This review seeks to call attention to new insights regarding the impact of sleep disturbance on cardiometabolic risk factors and outcomes and then apply these concepts to African descent populations, a relatively understudied population. Initial data suggest disparities in sleep quality may have an important role in current and emerging patterns of cardiometabolic disease for African descent populations both in the United States and abroad. CLINICALTRIALSGOV IDENTIFIER Not applicable.
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Affiliation(s)
- Peter L. Whitesell
- Howard University Hospital Sleep Disorders Center, Washington, DC, United States
| | - Jennifer Obi
- Department of Internal Medicine, Howard University Hospital, Washington, DC, United States
| | - Nuri S. Tamanna
- Howard University Hospital Sleep Disorders Center, Washington, DC, United States
| | - Anne E. Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases and National Institute of Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD, United States
- *Correspondence: Anne E. Sumner,
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Differences in Sleep Duration among Four Different Population Groups of Older Adults in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050502. [PMID: 28486421 PMCID: PMC5451953 DOI: 10.3390/ijerph14050502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 12/21/2022]
Abstract
The study aims to investigate sleep duration in four different population groups in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) Wave 1. A national population-based cross-sectional study with a sample of 3284 aged 50 years or older in South Africa was conducted in 2008. The questionnaire included socio-demographic characteristics, health variables, and self-reported sleep duration. Results indicate that White Africans compared to other population groups had the lowest mean sleep duration (7.88 h among men and 7.46 h among women). The prevalence of short sleep was the highest among both men and women among the White African (18.8% in men and 16.9% in women) and Indian or Asian African population groups (14.5% in men and 17.1% in women), and lowest among both men and women in the Black African (7.0% in men and 6.5% in women) and multi-ancestry population groups (15.6% in men and 12.7% in women). The prevalence of long sleep was among both men and women the highest in the Black African population group (56.2% in men and 58.5% in women), and the lowest in the White African population group (36.4% in men and 24.3% in women). In a Poisson regression model, adjusted for sociodemographics and chronic disease status, coming from the male and female White African population group was associated with short sleep. In addition, coming from the Indian or Asian African population group was associated with short sleep. No population group differences were found regarding long sleep prevalence. White Africans reported more short sleep duration than the other population groups, while there were no racial or ethnic differences in long sleep. White Africans are more likely to have sleep durations that are associated with negative health outcomes. An explanation of the high short sleep prevalence among White Africans may be related to their racial or ethnic minority status in South Africa.
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