Knowledge, beliefs and practice of sleep hygiene as a determinant of insomnia among the employed adult population of Yerevan

Abstract

Background: Sleep is a crucial phenomenon that involves complex metabolic and nervous activities that help the human body grow, maintain and repair itself. A lot of key players in human physiology responsible for health are involved and enhanced during sleep. Insomnia is a sleep disorder distinguished by disruption of normal sleep and therefore restoration from sleep on the next day. It impacts the day to day activities of the individual and, overall, results in impairing consequences on general wellbeing. Its symptoms are reflected upon sleep initiation, maintenance, quality and morning awakening. Insomnia is of biological and psychological nature and is associated with immense physical and mental comorbidity. Its risk factors include older age, female sex, morbid conditions, mediocre sleep hygiene, alcohol and substance abuse, medications, and type of work shift. The public health burden of insomnia is characterized by its high prevalence and association to a variety of health conditions. Moreover, the personal burden is quite high due to impairment of quality of life, daytime functioning and social relationships. Lastly, the economic losses associated by absenteeism and low productivity of the insomniac person at the workplace are substantial. Different types of treatments for insomnia are suggested but with arguable scientific evidence supporting each. Sleep hygiene therapy and/or education is one of those treatments with no empirical evidence supporting its efficacy since sleep hygiene was proven effective in treating insomnia only in conjunction with behavioral interventions. Sleep hygiene is a set of practices - during the day and at bedtime - and conditions of the surrounding sleep environment that promote high quality restorative sleep. Poor sleep hygiene shows significant association with insomnia and other sleep disorders and therefore deserves attention. Data about Armenia reflects a prevalence of any insomnia complaint of 52.5% among the general adult population, and is no different from the profile of the burden revealed in the literature. The association of sleep hygiene and insomnia among population of Armenia has not been studied before. Study aim and research questions: The aim of this study is to examine Knowledge, Beliefs and Practice (KBP) of Sleep Hygiene as a determinant of insomnia among employed adult population of Yerevan of age 18 and above through (1) Estimation of mean KBP score of sleep hygiene among the employed adult population of Yerevan, (2) Assessment of insomnia prevalence among the employed adult population of Yerevan, and (3) Testing for association between insomnia status and sleep hygiene KBP subdomain scores. Methods: A cross-sectional household survey will be conducted and data collection will be done through interviewer-administered surveys. The target population is the employed adult population of Yerevan. The instrument of the study captures knowledge, beliefs and practices of sleep hygiene, insomnia status, covariates and sociodemographic variables. Double data entry, data merging and cleaning will be done in an SPSS database. Statistical analyses will include descriptive statistics for all variables, bivariate comparisons between insomnia and non-insomnia groups by running student t-tests for indiscrete variables, chi squared tests for categorical variables, and fitting three logistic regression models to test for significance of association between insomnia status and the three sleep hygiene subdomains. Ethical Considerations: The Institutional Review Board of the American University of Armenia approved the planned grant proposal. Logistical considerations: The proposed study will last for four months and will include a team consisting of a project director, statistician, data collectors and data entry operators. The estimated amount of funds to be allocated for this study is 4,130,000 AMD.