Factors that Affect the Sleep of Women in Informal Settlements in Kenya

Abstract

Abstract Background Sleep is essential for overall health and well-being. Most sleep quality and health research focuses on high-income countries. Less is known about the sleep quality of women residing in lower and middle-income Countries (LMICs), including Kenya. Many physical, psychological, cultural, and environmental factors influence quality of sleep. There is limited research focused on sleep quality among women in LMICs, and no research explicitly focused on women in informal settlements in these countries; yet, women in informal settlements in LMICs often face challenges that could severely affect sleep health. Through an exploratory mixed-methods study, we explore rates of sleep quality and self-reported factors associated with sleep disturbance among a probability sample of n = 800 women in two informal settlements in Nairobi, Kenya. Findings will contribute to the knowledge base regarding sleep quality within populations in informal settlements, which may inform tailored interventions and policies designed to nurture the distinct sleep needs of people living in LMICs. Methods Data were collected in September 2022. The data were part of the baseline of an 18-month longitudinal cohort study examining mental health and climate change among women living in two informal settlements in Nairobi–Mathare and Kibera. Items from the Brief Pittsburgh Sleep Quality Index (B-PSQI) were collected to examine women's sleep habits and quality of sleep. Quality of sleep scores were calculated. Open-ended questions were asked about factors contributing to sleep disturbance, and a thematic analysis was conducted to summarize the findings. Findings: Just under 29% of women (N = 229) met the criteria for poor quality sleep. Open-ended findings identify stress as the main factor affecting sleep. Childcare, financial instability, physical health, climate, grief, and loss also impacted women's sleep. Interpretation: The findings of this paper highlight the need for more research focused on sleep quality in informal settlements in LMICs, especially among women. We suggest that interventionists and policymakers can develop targeted interventions and policies to improve sleep quality and address risk factors by better understanding this population's specific challenges and enhancing overall awareness and education of sleep and its importance for health in these communities.