Sleep Quality among Primary Care Attendees in Kaduna, Northern Nigeria: A Case-Control Study

Abstract

Objective: To assess sleep quality and its determinants among primary care patients in a Northern Nigerian setting. Methods: We administered the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale to 217 consecutive patients attending the General Outpatient Clinic of Barau Dikko Specialist Hospital, Kaduna, and PSQI to 223 age-matched controls to evaluate their sleep quality and levels of anxiety and depression. A data collection sheet was used to record the sociodemographic characteristics of patients and controls, and the clinical characteristics of the patients. Results: The mean ages of all the subjects, patients, and controls were 33.7 ( SD 10.6), 33.5 ( SD 10.6), and 34.0 ( SD 10.5) years respectively; 54.4% of the patients were females, 54.8% were Muslims, 56.2% admitted they had pain, 60.8% and 46.5% had anxiety and depressive symptoms respectively, while 68.7% had poor sleep quality. The mean global score of sleep quality for patients was 9.2 ( SD 3.6) while that of the control was 3.8 ( SD 1.4). The difference was statistically significant ( t = 20.834, P value < 0.001, 95% CI 4.891–5.910). Islamic religious faith, presence of pain, anxiety symptoms, and depressive symptoms were significantly associated with poor quality of sleep ( P value < 0.05). Multiple regression analysis identified being a Muslim (OR 6.422, P value 0.027, 95% CI 0.196–0.907), pain (OR 8.038, P value < 0.001, 95% CI 0.016–0.091), and anxiety symptoms (OR 5.253, P value < 0.001, 95% CI 0.136–0.473) as predictors of poor sleep quality among the patients. Conclusion: Poor quality of sleep is common in primary care patients. Efforts should be made to improve its recognition, identify associated factors, and consider a holistic approach to patients' care.