How do individuals sleep around the world? Results from a single-day survey in ten countries

McGill University, Montréal, Quebec, Canada
Sleep Medicine (Impact Factor: 3.15). 02/2005; 6(1):5-13. DOI: 10.1016/j.sleep.2004.10.006
Source: PubMed


To describe between-country differences in both the prevalence and type of sleep disorders seen across the globe, and to provide information on how impaired sleep impacts daytime functioning.
The study is a large-scale, global cross-sectional survey conducted on International Sleep Well Day (March 21), 2002. A standardized questionnaire was used in 10 countries under the guidance of local survey managers. In addition, the Athens Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS) were completed. Subjects included in the study were adults from 10 countries representing different continents with clear variations in lifestyle.
The total number of questionnaires collected was 35,327. Overall, 24% of subjects reported that they did not sleep well. According to self-assessments using the AIS, 31.6% of subjects had 'insomnia', while another 17.5% could be considered as having 'sub-threshold insomnia'. According to ESS scores, 11.6% of subjects were found to be 'very sleepy' or 'dangerously sleepy' during the day.
Although there seem to be important global variations in the prevalence of insomnia, its symptoms and their management, about one in four individuals do not think they sleep well. Moreover, self-reported sleep problems could be underestimated in the general population. Overall, there is a need for increased awareness of the importance of disturbed sleep and the improved detection and management of sleep disorders.

24 Reads
  • Source
    • "" The prevalence of alcohol use as a sleep aid one or more times per week was 48.3% among men, and 18.3% among women in Japan, which is higher than in other countries (Kaneita et al., 2007). The use of alcohol appears to be a more popular sleep aid than hypnotic medication or consulting doctors (Soldatos et al., 2005; Kaneita et al., 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Lifestyle-focused health programs are growing in interest throughout Western society, and a range of lifestyle factors are known to enhance both physical and mental health. However, it remains largely unknown as to whether this approach is salient for the Asian context. The major components of integrative lifestyle-focused health programs to enhance mental and physical health are considered to include the evidence-based adoption of physical activity and exercise, dietary modification, general psychoeducation, adequate relaxation/sleep and social interaction, use of mindfulness techniques, the reduction of substance use, attention of intersecting environmental factors, and the potential use of motivation and goal-setting techniques. This paper outlines an overview of the evidence underpinning these elements, and discusses potential barriers and challenges, and what logistical considerations may need to be addressed in the implementation of such programs within the context of Asian cultures.
    Asia-Pacific Psychiatry 09/2015; 7(4). DOI:10.1111/appy.12212 · 0.63 Impact Factor
    • "Though the majority of these individuals reported functional impairment as a result of their sleep problems, most (61e79%) did not meet clinical diagnostic criteria for insomnia based on selfreported symptoms [7]. In a similar survey of adults representing 10 countries, 31.6% of participants were classified as having insomnia while an additional 17.5% of participants were classified with subthreshold insomnia [8]. Sleep problems are of growing concern to global public health because poor sleep is associated with impairments in motivation, emotion, and cognitive functioning as well as increased risk for serious medical conditions (e.g., diabetes, cardiovascular disease, cancer) and all-cause mortality, even when the symptoms are below the threshold for clinical sleep disorders [9e11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Sleep Medicine Reviews 10/2014; 22. DOI:10.1016/j.smrv.2014.10.001 · 8.51 Impact Factor
  • Source
    • "The Epworth sleepiness scale was created in 1991 as a tool to quantify levels of daytime sleepiness and it has been used in a large number of clinical studies [3] [4]. Prevalence of EDS in the general population, defined by the ESS, in different countries ranges from 6.2 to 32.4% [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] (Table 1), with a moderate heritability of approximately 38% to 40% [18] [19] [20] [21]. This evidence highlights the importance of studying the role of genetic polymorphisms in increased diurnal somnolence [22]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Excessive daytime sleepiness (EDS) is one of the main causes of car and industrial accidents and it is associated with increased morbidity and alterations in quality of life. Prevalence of EDS in the general population around the world ranges from 6.2 to 32.4%, with a heritability of 38-40%. However, few studies have explored the role of candidate genes in EDS. Monoamine oxidase A (MAOA) gene has an important role in the regulation of neurotransmitter levels and a large number of human behaviors. We hypothesized that a functional VNTR in the promoter region of the MAOA gene might be associated with daytime sleepiness in healthy individuals. The Epworth sleepiness scale (ESS) was applied to 210 Colombian healthy subjects (university students), which were genotyped for MAOA-uVNTR. MAOA-uVNTR showed a significant association with ESS scores (p=0.01): 3/3 genotype carriers had the lowest scores. These results were supported by differences in MAOA-uVNTR frequencies between diurnal somnolence categories (p=0.03). Our finding provides evidence for the first time that MAOA-uVNTR has a significant association with EDS in healthy subjects. Finally, these data suggest that functional variations in MAOA gene could have a role in other phenotypes of neuropsychiatric relevance.
    Journal of the neurological sciences 12/2013; 337(1-2). DOI:10.1016/j.jns.2013.12.005 · 2.47 Impact Factor
Show more