Oluwatosin Eunice Olorunmoteni

Sleep health in adolescence is a global public health concern. However, limited studies on adolescent sleep health in Africa exist, and the extent of the available literature on the African continent has not been previously mapped. This review aimed to map the studies on adolescent sleep health in Africa with a focus on the geographical distribution, publication trends, pattern of sleep health measures, prevalence of sleep disorders, the barriers and facilitators to good sleep health, rural-urban disparities, as well as the associations of sleep health with mental health, school schedule and cardio-metabolic risk among the adolescents. All published articles on adolescent sleep health in Africa in English, French, Spanish, Portuguese, and Italian languages were to be included. We conducted a scoping review by searching five databases: MEDLINE (via PubMed), CINAHL (via EBSCOHost), PsycINFO (via EBSCOHost), Scopus, and the African Journal Online (AJOL), from the inception of the databases to January 2025. As previously highlighted in our published protocol, we used the JBI methodology for the scoping review. After screening 921 titles and abstracts and 78 full-text articles, we included 43 articles. There has been an increasing number of studies on adolescent sleep in Africa in the past 25 years. Cross-sectional studies were the most frequent design (67.4%). Most studies focused on sleep quantity and quality, with small sample sizes and scanty evidence on other aspects of sleep health. Inadequate weekday sleep duration was common among adolescents, often compensated by longer weekend sleep durations. Screen use at bedtime, sleeping environment, school schedules, and chronic medical conditions were the major risk factors for sleep disturbances. Poor sleep was associated with poor academic performance, depression, anxiety, and adverse cardiometabolic risk. This review shows a lack of studies on the multidimensional aspects of sleep health and the need for more objective sleep measures to better characterise the sleep health of adolescents in Africa. Larger studies with longitudinal and mixed-method designs are needed to drive the planning and execution of interventions to improve sleep health among African adolescents.

There is limited evidence on the association between sleep health and cardio-metabolic risk (CMR) in Sub-Saharan African adolescents. Using a cross-sectional design, we assessed the association between sleep health and CMR, including 900 adolescents aged 13–19, attending six rural and six urban schools, in Osun State, Nigeria. Sleep health variables included sleep quality and duration (Pittsburgh Sleep Quality Index), risk of sleep apnea (Teen STOPBANG), and daytime sleepiness (Epworth Sleepiness Scale for Children and Adolescents). A continuous CMR-score was calculated using z-scores of mean arterial pressure (MAP), body mass index (BMI), waist circumference (WC), and random blood glucose. We analysed the association between sleep health, place of residence, and CMR using generalized linear models. Urban adolescents presented worse sleep health indicators and higher BMI, WC, and CMR-score ( p < 0.05). Overall, poorer sleep quality was associated with higher CMR-score (β = 0.02), BMI z-score (β = 0.04), and WC z-score (β = 0.03) ( p < 0.05), and lower sleep duration with higher CMR-score (β = 0.04), BMI z-score (β = 0.11), and WC z-score (β = 0.07) ( p < 0.05). Risk of sleep apnea was associated with higher CMR-score (β = 0.08), MAP z-score (β = 0.17), and WC z-score (β = 0.14) ( p < 0.05). Improving the sleep health of adolescents may prevent cardiometabolic diseases later in life.

Globally, most children and adolescents live in low- and middle-income (LAMI) countries. Despite the high and under-recognized mental health burden in these settings, there is little systematic research to inform cost-effective mental health interventions. Identifying causal risk and protective mechanisms is important to inform such interventions. Longitudinal genetically informative designs can help identify potentially causal environmental mechanisms in the etiology of childhood psychopathology but few have been carried out in LAMI settings. We tested the feasibility of a twin-family study in a semi-urban setting in South-Western Nigeria. We recruited 320 family units, each comprising at least one parent and both twins aged 2.5–5.9 (x̄ = 4.0 ± 0.92) years from two towns using five strategies: direct and indirect contacts, radio adverts, cluster sampling (based on local administrative units) and snowball sampling. Participants were asked about their willingness to participate in future research including providing biological samples. These were supplemented with participant engagement activities before and after data collection. Snowball sampling was the most effective strategy while cluster sampling was the least effective (recruiting 46.3% and 8.3% of participants, respectively). Direct contacts and cluster sampling appeared prone to excluding under-represented participants. A large proportion of the participants (98–99%) were willing to participate in future studies. Challenges included grant administration (finance and ethical priorities) and desirability bias. Twin research is feasible in LAMI sub-Saharan Africa, with snowball sampling being an efficient means of recruiting a diverse sample. Participant involvement and engagement is useful to inform the execution of genetically-informative research in a LAMI context.

This study aimed to assess the knowledge and perception of Nigerian paediatricians regarding paediatric sleep disorders and their management. It also assessed the state of their current practice with screening, evaluating and treating sleep disorders in children and the perceived barriers and facilitators to the provision of quality care for sleep disorders for Nigerian children. This descriptive cross-sectional study was conducted among 153 Paediatricians who practice in Nigeria and attended the Annual Scientific Meeting of the Paediatrics Association of Nigeria (PAN) held in January 2023 at Akure, Ondo state, Nigeria. We utilized a pilot-tested, semi-structured questionnaire adapted from the Paediatrics sleep survey questionnaire. Data was analysed with the IBM SPSS software, version 20. The 153 respondents were from the six geopolitical zones in Nigeria. More than two-thirds (66.7%) had a poor knowledge score (<6). The majority of the respondents rated their confidence in diagnosing sleep disorders as fair (63.4%), while 22.2% rated it as poor. Almost all (98.7%) reported the lack of sleep laboratory in their centre of practice. Also, about two-thirds (68.0%) had no paediatric sleep clinic. The main barriers to the management of paediatric sleep disorders were lack of training (119; 77.3%) and lack of sleep laboratory (102; 66.7%). Having a sleep laboratory in the centre of practice was significantly associated with the knowledge of the paediatricians (p = 0.044). There is a need for interventions to improve the knowledge of Nigerian paediatricians on sleep medicine and the provision of Paediatric sleep laboratory facilities in Nigeria.

Background: Adequate sleep is crucial for well-being. Long hours of work observed among resident and intern doctors disrupt sleep and promote health risks and sleep-induced morbidity and mortality. Aim: This study aimed to examine the impact of extended work hours on the quality, patterns, and sleep duration among ID and RD in Nigeria. Methods: This analytical cross-sectional study involved participants from hospitals across Nigeria's six geopolitical zones. Data were collected via a 32-item electronic questionnaire assessing socio-demographic details, sleep history, daytime sleepiness, and insomnia severity. Statistical analysis was performed using Stata 18 software. Bivariate analysis was done using the appropriate tools. The Jonckheere–Terpstra test was used to compare the weekly work hours in the Insomnia Severity Score categories. Results: Significant daytime sleepiness was reported among interns and resident doctors, with mean (SD) Epworth Sleepiness Scale scores of 11.04 (4.702) for residents and 10.91 (4.202) for interns. The insomnia severity scores were also in the moderate to high categories, with a mean (SD) of 9.77 (6.659) for residents and 11.39 (6.143) for interns. Burnout symptoms were frequently reported among 70 residents (42.9%) and 20 (33.9%) interns. An increased prevalence of specific sleep disorders, particularly insomnia, nightmares, and sleep-related breathing problems, was observed. Conclusion: The study found that resident and intern doctors in Nigeria suffer from poor sleep quality and burnout syndrome, highlighting the significant burden of sleep-related issues that could negatively impact their work performance and the quality of patient care.

Sleep problems are common in children with cerebral palsy (CWCP). However, the effect of sleep problems in CWCP on caregivers has not been well studied. We aimed to describe the sleep problems in CWCP and their caregivers, and explore the effect of the children's sleep on the caregivers' sleep. This cross-sectional, mixed-methods research was conducted at a pediatric neurology clinic in Ile-Ife, Nigeria. The Sleep Disturbance Scale for Children (SDSC) and Pittsburgh Sleep Quality Index (PSQI) were used for assessing sleep problems of the children and their caregivers, respectively. We held three focused group discussions (FGDs) involving 18 caregivers using a pretested FGD guide. We analyzed the quantitative data using Stata-15 software, while qualitative data were transcribed and managed using ATLAS.ti Software. We studied 71 CWCP–caregiver dyads and 69 age- and sex-matched controls. There was a male preponderance for CWCP (M:F = 1.09:1) and female preponderance for caregivers (89.5%). Sleep disturbances (SDSC > 40) occurred in 34% of CP children and poor sleep quality was seen in 39% of caregivers. When compared with age- and sex-matched typically developing peers, there was a statistically significant higher sleep disturbance in CWCP (p = 0.009). Sleep difficulties in the CWCP comprise sleep–wake transition disorders (45.0%), difficulty initiating sleep (43.3%), and sleep breathing disorders (37.5%). Caregivers experienced short sleep duration. One mother said: “It affects my sleep, health, and work. It affects everything about me.” Sleep problems in CWCP affect the well-being of their caregivers. Interventions targeted at both the children and their caregivers are needed.

Introduction: Adolescence is a transitory phase marked by significant changes. While adolescents are not exempted from the increasing prevalence of sleep-related issues, an urgent need for understanding the factors responsible for sleep problems in this age group and evaluating the possible interventions to mitigate this scourge has risen globally. However, despite facing substantial sleep-related issues, there has been no focus on adolescents in low-middle-income countries (LMICs). This study seeks to serve as a much-needed tool to evaluate and compare the different interventions for adolescents with sleep-related problems in LMICs and provide valuable insights to stakeholders involved with adolescents to improve overall adolescent health. Methods and Analysis: The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis [PRISMA] guideline 2020. Eligible studies for this review will be identified following an exhaustive literature search on the following databases: PubMed, Embase, Scopus, PsychInfo, and AJOL. Our outcomes will include quantitative measures of sleep health and other health indicators. Data will be presented qualitatively using tables and diagrams, with narrative synthesis. Two independent reviewers will screen, review, and extract data from studies, with a third reviewer resolving discrepancies. Additionally, we will assess study details, the risk of bias, and the strength of evidence using the Grading of Recommendations Assessment, Development, and Evaluation framework. Ethics and dissemination: This review will be conducted using existing studies; hence, ethical approval will not be required. We aim to present our findings at conferences and publish our manuscript in a peer- reviewed journal for widespread dissemination.

Introduction Problematic sleep is a major threat to health and quality of life among adolescents. Hence, to provide directions for research and interventions, there is a need to examine the literature on adolescent sleep health in Africa. However, available studies on adolescent sleep health in Africa have not been properly mapped. Thus, this scoping review aims to investigate the extent and type of available evidence concerning sleep health among adolescents in Africa and to highlight the relationship of adolescent sleep health with adverse mental health outcomes and cardiometabolic risk factors. The review will further highlight areas of agreement and controversies on adolescent sleep health, and identify evidence gaps that require research attention across the continent. Methods and analysis This scoping review will be conducted using Arksey and O’Malley’s six-step procedure. Thus, we have prepared this protocol according to the framework for scoping reviews developed by the Joanna Briggs Institute. To identify eligible studies, we will search MEDLINE, Scopus, PsycINFO, AJOL, JSTOR, HINARI and Google Scholar. The review will include all published articles in English, French, Spanish, Portuguese and Italian languages on adolescent sleep health in Africa from the inception of the databases, while relevant information will be extracted from included studies using an adapted data extraction tool. The results will be presented using tables and charts as appropriate. Ethics and dissemination The scoping review does not require ethical approval because the publications to be used for the review are publicly available and the study does not involve contact with humans or other animals as research participants. Furthermore, clinical records will not be used for the study. Upon completion, findings from the study will be disseminated through presentations at scientific meetings and publication in a relevant peer-reviewed journal. Scoping review registration Open Science Framework (https://osf.io/5sjwq/).

Purpose Sleep medicine is a rapidly growing field of Medicine globally. However, studies are lacking on the knowledge of Nigerian medical and dental students on sleep and the different types of sleep disorders. Thus, we assessed the knowledge, interest and awareness of Nigerian medical and dental students about sleep medicine. We also determined the factors associated with sleep knowledge among the medical and dental students. Methods We conducted this cross-sectional study from June to September 2021, among medical students at the Obafemi Awolowo University, Ile-Ife, Nigeria. The students’ knowledge of sleep was assessed with the Assessment of Sleep Knowledge in Medical Education (ASKME) survey. The participants were classified as having low or high scores based on the proportion who gave a correct answer to 60% of the questions. Results Among the 488 students who completed the questionnaire, there was a male preponderance (55%). About three-quarters of the respondents (376, 77%) had a low sleep knowledge score. Age, year of study, and awareness about sleep medicine were the predictors of sleep knowledge. Conclusion A significant proportion of the medical students had poor sleep knowledge scores. There is a need to incorporate teaching sleep medicine in the curriculum of medical students early in their training.