PREVALENCE OF SLEEP DISTURBANCES AND THEIR ASSOCIATION WITH SCREEN TIME, PHYSICAL ACTIVITY, AND PSYCHOLOGICAL STRESS AMONG ADULTS ATTENDING PRIMARY HEALTHCARE CENTERS: A CROSS-SECTIONAL STUDY

Mareh Adeeb Ahmed*

ABSTRACT

Background: Sleep disturbances have become an important public health concern because of their potential effects on occupational performance, social relationships, and long-term health outcomes. Screen time, physical activity, and psychological stress are potentially modifiable factors that may influence sleep quality among adults. This study aimed to determine the prevalence of sleep disturbances and assess their association with screen time, physical activity, and psychological stress among adults attending primary healthcare centers. Methods: A facility-based cross-sectional study was conducted among 412 adults aged 18 years and older attending primary healthcare centers. A non-probability consecutive sampling technique was used to recruit eligible participants. Data were collected using a structured questionnaire comprising sociodemographic and clinical characteristics, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep disturbances (defined as a global score >5), the International Physical Activity Questionnaire short form (IPAQ-SF) to assess physical activity, and the Perceived Stress Scale (PSS) to assess psychological stress. Data were analyzed using descriptive statistics, chi-square tests, independent-samples t-tests or Mann–Whitney U tests, and multivariable logistic regression. A p-value of <0.05 was considered statistically significant. Results: The mean age of participants was 38.7 ± 12.4 years, and 58.5% were female. The overall prevalence of sleep disturbances was 61.4% (95% CI: 56.7%–66.1%), with a mean global PSQI score of 8.97 ± 3.64. The prevalence of sleep disturbances increased significantly across screen time categories (42.6% for <2 hours, 57.1% for 2–4 hours, and 72.7% for >4 hours; p < 0.001) and stress categories (42.9% for low stress, 63.3% for moderate stress, and 79.6% for high stress; p < 0.001), and decreased significantly with increasing physical activity levels (71.3% for low, 59.6% for moderate, and 50.0% for high activity; p = 0.002). In multivariable logistic regression, screen time >4 hours per day (AOR = 2.87, 95% CI: 1.54–5.35, p = 0.001), low physical activity (AOR = 1.94, 95% CI: 1.11–3.39, p = 0.020), and higher perceived stress (AOR = 1.15 per 1-point increase, 95% CI: 1.10–1.21, p < 0.001) remained independently and significantly associated with sleep disturbances after adjusting for potential confounders. Conclusion: A high prevalence of sleep disturbances was observed among adults attending primary healthcare centers. Screen time exceeding 4 hours per day, low physical activity, and higher perceived psychological stress were independent correlates of poor sleep quality. These findings highlight the need for integrating sleep assessment into routine primary care and implementing multi-component interventions targeting screen time reduction, physical activity promotion, and stress management to improve sleep health in this population.

Keywords: Sleep disturbances, Pittsburgh Sleep Quality Index, screen time, physical activity, psychological stress, primary healthcare centers, cross-sectional study.