Epidemiology of sleep health and associations with mental health among in-school adolescents in Uganda: A cross-sectional mixed-methods study

Namirembe, Prossy, Nanyonga, Beatrice, Ndekezi, Denis, Nyangoma, Betty, Kyomugisha, Rebecca, Nyaruhuma, Aaron, Ateo, Claudia, Rutainama, Calvin Robert, Thomas, Katherine A, Batuusa, Ratifah, Muhindo, Benson, Kasabiiti, Sheila, Alezuyo, Connie, Kyegombe, Nambusi, Bonell, Chris, Michelson, Daniel, Baker, Fiona C., Orchard, Faith, Mbazzi, Femke Bannink and Weiss, Helen A (2025) Epidemiology of sleep health and associations with mental health among in-school adolescents in Uganda: A cross-sectional mixed-methods study. Sleep Health. ISSN 2352-7226 (In Press)

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Abstract

Objectives: Few studies have examined sleep health among African adolescents. We aimed to understand sleep health among Ugandan secondary school students. Methods: We collected quantitative data in two schools through a survey with items on sleep health and insomnia (using the Cleveland Adolescent Sleepiness Questionnaire, Munich Chronotype Questionnaire and Insomnia Severity Index (ISI)) and mental health with the UNICEF Measuring Mental Health Among Adolescents and Young People at the Population Level (MMAPP) tool. We used regression models to assess characteristics associated with ISI score, and of sleep health with depression and anxiety. We conducted focus group discussions and in-depth interviews with students, parents, teachers, and officials. Quantitative and qualitative analyses were guided by the social ecological model of sleep health. Results: The 358 participants generally reported poor sleep health (assessed by satisfaction, alertness, timing, efficiency and duration), especially among boarding students. The median sleep duration was 5.1 hours (interquartile range 4.2-6.2). Overall, 36 (10.1%) participants screened positive for moderate/severe insomnia (ISI>15), with higher prevalence among females than males (12.7% vs 6.2%; p=0.05). Qualitative interviews highlighted that individual (knowledge and attitudes), social-cultural (religious beliefs, family dynamics, academic demands, peer pressure), environmental (school and home conditions, technological influences), and societal factors (national school schedule guidelines) influenced sleep patterns. Depression and anxiety were associated with multiple dimensions of poor sleep health. Conclusions: Ugandan adolescents face substantial sleep challenges, which are associated with poor mental health. Evidence-based interventions should be adapted for specific social-ecological contexts to improve sleep and mental health in this population.

Item Type:	Article
Additional Information:	Data sharing: The data are available on request from LSHTM Data Compass
Uncontrolled Keywords:	insomnia,depression,anxiety,sleep quality,sleep hygiene,students,africa,sdg 3 - good health and well-being,3* ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Social Sciences > School of Psychology
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health)
Depositing User:	LivePure Connector
Date Deposited:	19 Jan 2026 15:30
Last Modified:	27 Jan 2026 13:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/101646
DOI:

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