How many hours do people sleep in Bangladesh? A country-representative survey

Sleep duration during the COVID-19 pandemic in Bangladesh: A GIS-based large sample survey study

Although several studies have been conducted in Bangladesh regarding sleep problems during the COVID-19 pandemic, none have utilized a large nationwide sample or presented their findings based on nationwide geographical distribution. Therefore, the aim of the present study was to explore the total sleep duration, night-time sleep, and daily naptime and their associated factors as well as geographic information system (GIS) distribution. A cross-sectional survey was carried out among 9730 people in April 2020, including questions relating to socio-demographic variables, behavioral and health factors, lockdown, depression, suicidal ideation, night sleep duration, and naptime duration. Descriptive and inferential statistics, both linear and multivariate regression, and spatial distribution were performed using Microsoft Excel, SPSS, Stata, and ArcGIS software. The results indicated that 64.7% reported sleeping 7-9 h a night, while 29.6% slept less than 7 h nightly, and 5.7% slept more than 9 h nightly. 43.7% reported 30-60 min of daily nap duration, whereas 20.9% napped for more than 1 h daily. Significant predictors of total daily sleep duration were being aged 18-25 years, being unemployed, being married, self-isolating 4 days or more, economic hardship, and depression. For nap duration, being aged 18-25 years, retired, a smoker, and a social media user were at relatively higher risk. The GIS distribution showed that regional division areas with high COVID-19 exposure had higher rates of non-normal sleep duration. Sleep duration showed a regional heterogeneity across the regional divisions of the country that exhibited significant associations with a multitude of socioeconomic and health factors.

Prevalence and correlates of total sleep time among the older adults during COVID-19 pandemic in Bangladesh

Purpose

The present study was aimed to identify inappropriate sleep duration and its correlates among the Bangladeshi older adults during the COVID-19 pandemic.

Material and methods

This cross-sectional study was carried out among 1030 older adults aged 60 years and above in Bangladesh. Information was collected through telephone interviews using a pretested semi-structures questionnaire installed in SurveyCTO mobile app. Sleep duration was defined as total sleep time (TST) in last 24 h including day and nighttime sleep. TST was further categorized into shorter (<7 h), recommended (7-8 h), and longer sleep (>8 h) according to 2015 National Sleep Foundation guideline. The multinomial logistic regression model identified the factors associated with sleep duration.

Results

Mean TST was 7.9 h (SD=1.62). Of the total participants, 28.2% had longer and 17.8% shorter sleep duration. In the regression model, participants' age of ≥80 years (OR: 3.36, 1.46-7.73), monthly family income of <5,000 Bangladeshi Taka (OR: 3.50, 1.79-6.82), difficulty in getting medicine during COVID-19 (OR: 1.72, 1.05-2.82), lack of communication during the pandemic (OR: 2.20, 1.43-3.40) and receiving COVID-19 related information from friends/family/neighbours (OR: 1.83, 1.11-3.01) were significantly associated with shorter TST. On the other hand, monthly family income of < 5,000 Bangladeshi Taka (OR: 2.00, 1.13-3.53), difficulty in getting medicine during COVID-19 pandemic (OR: 2.01, 1.33-3.03) and receiving COVID-19 related information from radio/TV (OR: 2.09, 1.22-3.59) were associated with longer TST.

Conclusions

The study findings suggest implementing sleep management program for older adults in Bangladesh, particularly during emergencies like COVID-19.

Predictive factors of insomnia during the COVID-19 pandemic in Bangladesh: a GIS-based nationwide distribution

Background

In a densely populated country like Bangladesh, mental health-related burden and associated adverse outcomes are quite prevalent. However, exploration of sleep-related issues in general, and more specifically of insomnia during the COVID-19 pandemic has been scarce and restricted to a single location. The present study investigated the prevalence of insomnia and its predictive factors in the general population, and included Geographic Information System (GIS) analysis to identify regional heterogeneities of insomnia in Bangladesh.

Methods

This cross-sectional study was conducted during the early period of the COVID-19 pandemic. Information related to socio-demographics, knowledge of COVID-19, behaviors related to COVID-19, fear of COVID-19, and insomnia were included in a questionnaire, and coupled with GIS-based spatial analysis to identify regional susceptibility to insomnia.

Results

Approximately 30.4%, 13.1% and 2.8% of participants reported sub-threshold, moderate, and severe forms of insomnia, respectively. Independent predictive risk factors of insomnia symptoms included female gender, college education, urban residence, presence of comorbidities, using social media, taking naps during daytime, and fear of COVID-19. District-wide variations in the spatial distribution of fear of COVID-19 and insomnia were significantly associated.

Conclusion

Insomnia is frequently present during a pandemic, and exhibits regional variability along with multifactorial determinants. These analytic approaches should enable improved detection and targeting of at-risk sectors of the population, and enable implementation of appropriate measures to ensure improved sleep quality.

Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population: Results from a Large Cross-Sectional Study

Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50–22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5–18.8) and 33.7% (95% CI: 32.9–34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11–1.71), older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89–2.86), for 60–69 years is 1.62 (1.36–1.93), for 50–59 years 1.34 (1.13–1.58) and for 40–49 years 1.05 (0.87–1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14–1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55–0.84), for second highest quintile 0.77 (0.65–0.91), for middle quintile 0.81 (0.69–0.94) and for second lowest quintile 0.89 (0.77–1.03)], urban residence (ARRR-0.66, 95% CI: 0.66–0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65–0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12–1.63), higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 2.27 (1.93–2.68), for second highest quintile 1.67 (1.44–1.94), for middle quintile 1.26 (1.10–1.46) and for second lowest quintile 1.07 (0.93–1.24), excess food availability [compared to food shortage, ARRR (95% CI) for excess food in the household is 1.29 (1.12–1.47) and for no shortage/no excess is 1.23 (1.09–1.38) and more frequent fruits consumption [compared to no fruits, ARRR (95% CI) for 5–7 days per week consumption is 1.61 (1.41–1.83) and for 3–4 days per week is 1.28 (1.16–1.41) and factors significantly associated with decreased risk of overweight included older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 0.77 (0.64–0.93), for 60–69 years is 0.82 (0.71–0.94), for 50–59 years 0.91 (0.80–1.04) and for 40–49 years 1.01 (0.89–1.15)] and smoking (ARRR-0.76, 95% CI: 0.68–0.86). Both underweight and overweight are prevalent in Bangladeshi adult population. Several demographic, socio-economic, dietary and lifestyle factors are associated with underweight and overweight in Bangladesh. Population level impact of these factors should be examined to design suitable public health and nutrition interventions to address this dual challenge.

Relationship of sleep pattern and snoring with chronic disease: findings from a nationwide population-based survey

OBJECTIVES

To investigate the association of total sleep time and presence or absence of snoring with chronic disease among the Bangladeshi adult population.

DESIGN

Cross-sectional survey.

SETTING

Urban and rural Bangladesh.

PARTICIPANTS

A total of 12,338 men and women aged ≥35 years.

MEASUREMENTS

Total sleep time was considered as the total hours of sleep in 24 hours. Furthermore, sleep time was categorized into <7, 7-9, and >9 hours according to National Sleep Foundation (2015) guidelines. Self-reported snoring history was captured and corroborated with their respective sleep partner/spouse in more than 80% cases. Registered physician-diagnosed current and/or previous cases of hypertension, diabetes, coronary heart disease, cancer, stroke, chronic obstructive pulmonary disease, and any other chronic conditions were counted.

RESULTS

Overall prevalence of at least 1 chronic disease in our study population was around 18%: men (15.4%) and women (20.0%). Hypertension has the highest prevalence (overall: 12.7%, men: 12.2%, women: 15%) followed by diabetes (4.9%), coronary heart diseases (3.2%), stroke (1.8%), chronic obstructive pulmonary disease (0.9%), and cancer (any type: 0.1%). Sleep pattern and snoring are significantly associated with all individual chronic disease except cancer. Sociodemographic, behavioral, and lifestyle variables were adjusted, and inadequate total sleep time (<7 hours) and snoring (yes/no) showed significant association with chronic disease status (risk ratio = 1.11, 95% confidence interval 1.00-1.22 and risk ratio = 1.20, 95% confidence interval 1.11-1.29, respectively).

CONCLUSION

Inadequate sleep and snoring are independently associated with chronic disease in Bangladeshi adult population and perhaps elsewhere.

Sleep-wake patterns and sleep quality in urban Georgia

Objectives

Sleep problems represent a worldwide health concern but their prevalence and impacts are unknown in most non-European/North American countries. This study aimed to evaluate sleep-wake patterns, sleep quality and potential correlates of poor sleep in a sample of the urban Georgian population.

Methods

Analyses are based on 395 volunteers (267 females, 128 males, aged 20-60 years) of the Georgia Somnus Study. Subjects completed the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory-Short Form. Sociodemographic information and self-reported height and weight were collected.

Results

43% of subjects had poor sleep quality (PSQI > 5). Further, 41% had low sleep efficiency, 27.6% slept 6 hours or less, 32.4% went to bed after midnight, 27.6% snored, 10.6% were taking sleep medication, and 26.8% had sleep maintenance problems as occurring three or more times a week. The latest bedtime, rise time, and gender effect on these variables were found in the age group 20-29 years. PSQI global score showed a significant age but not gender difference. The economic status and the depression score were two significant predictors of sleep quality.

Conclusions

Poor sleep quality has a high prevalence and is strongly linked to the economic status. Study findings call for a global assessment of sleep problems in countries where sleep disturbances represent an insufficiently recognized public health issue.