Sleep problems and associated factors in a rural population of a Southern Brazilian city

Machado, Adriana Kramer Fiala; Wendt, Andrea; Wehrmeister, Fernando César

doi:10.11606/S1518-8787.2018052000260

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Rural Health Supplement, Original Articles • Rev. Saúde Pública 52 (suppl 1) • 2018 • https://doi.org/10.11606/S1518-8787.2018052000260 linkcopy

Sleep problems and associated factors in a rural population of a Southern Brazilian city

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To estimate the average of a sleep problems score and their associated factors in adults living in rural areas.

METHODS A population-based cross-sectional study with individuals from the rural area of the city of Pelotas, Southern Brazil. Twenty-four of the 50 census tracts that make up the eight rural districts of the city were randomly selected. Individuals of 18 years of age or older residing in the households chosen were considered eligible. Sleep problems were measured using the Mini Sleep Questionnaire, which ranged from 10 to 70 points and the higher the score, the greater the sleep problems. The independent variables evaluated included socioeconomic, demographic, behavioral and health characteristics. In the analysis, linear regression was used, obeying a previous hierarchical model.

RESULTS The sample consisted of 1,421 individuals. The average obtained for sleep problems was 29.4 points (95%CI 28.7–30.1). After adjusted analysis, the following variables were associated factors for greater sleep problems: female sex, age greater than or equal to 40 years, lower schooling level, depressive symptoms, pesticide poisoning, and poorer quality of life.

CONCLUSIONS The Mini Sleep Questionnaire average in this study was 4.4 points above the cut-off point that established sleep problems. The total points found in the score was high for the rural population. Strategies to improve sleep for these individuals should be focused on higher-risk groups such as women and the elderly and those with pesticide poisoning.

Sleep Wake Disorders, epidemiology; Agrochemicals, adverse effects; Cross-Sectional Studies; Rural Population

Variable	Total	MSQ	p^a

	n (%)	Average (95%CI)
Gender			< 0.001
Male	686 (48.2)	27.6 (26.8–28.5)
Female	735 (51.8)	31.0 (30.2–31.8)
Skin color			0.927
White	1,211 (85.0)	29.3 (28.6–30.1)
Black or brown	181 (12.9)	29.4 (28.2–30.7)
Others	29 (2.1)	30.0 (25.9–34.1)
Age (years)			< 0.001
18–24	166 (11.7)	26.3(24.9–27.7)
25–39	333 (23.6)	28.7 (27.6–29.8)
40–59	561 (39.5)	30.3 (29.3–31.3)
60 or older	361 (25.2)	30.0 (29.0–30.8)
Romantic partner			0.002
No	400 (28.2)	28.0 (27.0–28.9)
Yes	1,021 (71.8)	29.9 (29.1–30.7)
Education (complete years)			< 0.001^b
0–4	524 (37.1)	30.8 (29.7–32.0)
5–8	528 (37.2)	29.3 (28.6–30.0)
9 or more	364 (25.7)	27.4 (26.6–28.1)
Assets index (quintiles)			0.440
5th (richest)	290 (18.8)	29.9 (28.4–31.4)
4th	296 (19.9)	29.7 (28.4–30.9)
3rd	282 (20.0)	30.0 (28.5–31.4)
2nd	283 (20.8)	29.7 (27.8–30.0)
1st (poorest)	260 (20.5)	28.9 (28.4–31.4)
Workplace			0.001
Urban area	123 (8.7)	26.9 (25.6–28.3)
Rural area	689 (48.4)	29.2 (28.1–30.2)
Both	59 (4.1)	28.1 (26.0–30.3)
Is unemployed	549 (38.8)	30.3 (29.4–31.2)
Pesticide poisoning			< 0.001
Never	1,226 (86.5)	29.0 (28.3–29.7)
Uncertain	109 (7.5)	31.8 (30.3–33.4)
Certain	85 (6.0)	31.9 (30.0–33.9)
Smoking			0.433
No	925 (64.8)	29.2 (28.2–30.1)
Yes	229 (16.4)	30.0 (28.8–31.2)
Former smoker	267 (18.8)	29.5 (28.5–30.4)
Alcohol consumption			0.983
No risk	1,300 (94.0)	29.4 (28.7–30.0)
At risk	121 (6.0)	29.4 (27.7–31.1)
Physical activity			0.748
Active	1,157 (84.8)	29.3 (28.6–30.0)
Inactive	208 (15.2)	29.5 (28.2–30.8)
Depression (symptoms)			< 0.001
No	900 (64.5)	26.8 (26.2–27.4)
Yes	492 (35.5)	34.1 (33.3–34.9)
Nutritional status (BMI)^c			0.030
Low weight/Eutrophic	475 (35.1)	28.8 (27.8–29.8)
Overweight	480 (35.2)	29.2 (28.1–30.2)
Obesity	404 (29.7)	30.2 (29.4–31.1)
Quality of life			< 0.001
Very good	185 (13.0)	25.5 (24.3–26.8)
Good	917 (64.5)	29.0 (28.1–29.8)
Very bad/Bad/Fair	318 (22.5)	32.8 (31.8–33.7)
Hypertension			< 0.001
No	946 (66.8)	28.2 (27.3–29.1)
Yes	473 (33.2)	31.9 (30.9–32.9)
Diabetes			< 0.001
No	1,282 (90.2)	29.1 (28.4–29.8)
Yes	137 (9.8)	32.5 (31.0–34.0)
Average Score (MSQ)	1,421 (100)	29.4 (28.7–30.1)

Level	Variable	Crude coefficient^a		Adjusted coefficient^a

		β	p^b	β	p^b
1	Gender		< 0.001		< 0.001^c
	Male	Ref		Ref
	Female	3.33 (2.42–4.24)		3.30 (2.38–4.21)
	Skin color		0.927
	White	Ref
	Black or brown	0.10 (-1.27–1.48)
	Other	0.66 (-3.44–4.77)
	Age (years)		< 0.001		< 0.001^c
	18–24	Ref		Ref
	25–39	2.39 (0.74–4.05)		2.26 (0.72–4.03)
	40–59	4.00 (2.53–5.46)		3.91 (2.41–5.40)
	60 or older	3.62 (1.91–5.33)		3.50 (1.83–5.18)
2	Romantic partner		0.002		0.058^d
	No	Ref		Ref
	Yes	1.96 (0.80–3.13)		1.33 (-0.46–2.70)
	Education (complete years)		< 0.001^e		< 0.001^d,e
	0–4	3.48 (2.25–4.72)		3.05 (1.68–4.42)
	5–8	1.96 (0.97–2.96)		1.75 (0.73–2.77)
	9 or more	Ref		Ref.
	Assets index (quintiles)		0.440
	5th (richest)	Ref
	4th	0.38 (-1.51–2.26)		-
	3rd	1.41 (-0.76–3.59)
	2nd	1.12 (-0.50–2.75)
	1st (poorest)	1.34 (-0.68–3.37)
3	Workplace		0.001		0.206^f
	Urban area	Ref		Ref
	Rural area	2.25 (0.36–4.14)		1.02 (-0.75–2.79)
	Both	1.22 (-1.45–3.88)		0.65 (-2.13–3.45)
	Is unemployed	3.38 (1.90–4.86)		1.69 (0.12–3.25)
4	Pesticide poisoning		< 0.001		< 0.001^g
	Never	Ref		Ref
	Uncertain	2.85 (1.30–4.39)		2.59 (1.08–4.10)
	Certain	2.93 (0.68–5.17)		3.02 (0.97–5.08)
	Smoking		0.433
	No	Ref
	Yes	0.85 (-0.47–2.16)		-
	Former smoker	0.28 (-1.07–1.63)
	Alcohol consumption		0.983
	No risk	Ref		-
	At risk	0.20 (-1.45–1.48)
	Physical activity		0.748
	Active	Ref
	Inactive	0.20 (-1.05–1.44)		-
5	Depression (symptoms)		< 0.001		< 0.001^h
	No	Ref		Ref
	Yes	7.32 (6.42–8.22)		5.91 (4.87–7.21)
	BMIⁱ		0.030		0.834^h
	Low weight/Eutrophic	Ref		Ref
	Overweight	0.39 (-0.89–1.66)		-0.27 (-1.29–0.76)
	Obesity	1.46 (0.43–2.49)		-0.19 (-1.13–0.74)
	Quality of life		< 0.001		< 0.001^h
	Very good	Ref		Ref
	Good	3.44 (1.89–4.98)		2.04 (0.65–3.44)
	Very bad/Bad/Fair	7.26 (5.80–8.72)		4.05 (2.49–5.60)
	Hypertension		< 0.001		< 0.001^h
	No	Ref		Ref
	Yes	3.70 (2.49–4.92)		2.36 (1.26–3.47)
	Diabetes		< 0.001		0.080^h
	No	Ref		Ref
	Yes	3.45 (1.88–5.01)		1.15 (-0.15–2.44)

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[TFN1] MSQ: Mini Sleep Questionnaire; BMI: body mass index

[TFN2] ^a Heterogeneity p-value.

[TFN3] ^b Trend p-value.

[TFN4] ^c Variable with the greater number of missing data (missings) (n = 1,359).