Abstract
Objective
To examine geographical variations in involvement in physical violence and sleep disturbance
among adolescents.
Design
Cross-sectional study.
Setting
Eighty-nine low- to middle-income and high-income countries
Participants
Adolescents 13-17 years of age.
Measurements
Multiple binary logistic regression analyses and meta-analyses were performed to assess
the link between physical violence (number of physical fights) and sleep disturbance
("mostly" or "always" experienced worry-induced sleep loss).
Results
Among 296,212 adolescents, 8.9% reported sleep disturbance (male: 7.5%, female: 9.6%),
with the highest prevalence among adolescents from the Eastern Mediterranean region
(14.1%) and high-income countries (14.1%). Overall, sleep disturbance prevalence increased
gradually with the increased episodes of physical violence. Adolescents who were involved
in physical violence once, 2-3 times, and 4+ times were respectively 18%, 26%, and
77% more likely than their counterparts to experience sleep disturbance (1 time: OR
1.18, 95% CI 1.13-1.24; 2-3 times: 1.26, 1.20-1.34; 4+ times: 1.77, 1.66-1.88). The
association between physical violence and sleep disturbance was observed in all regions
and country-income groups, with the highest odds of sleep disturbance among adolescents
experiencing 4+ times of physical violence in the European region (2.34, 1.17-4.67)
and upper-middle-income countries (1.91, 1.73-2.11). The association of physical violence
with sleep disturbance by sex was significant in all regions and country-income groups,
except the European region.
Conclusions
Exposure to physical violence is associated with increased odds of sleep disturbances
in adolescents. School and community-level interventions, vigilance, and programs
to promote violence-free environments may improve the sleep health of adolescents
exposed to physical violence.
Keywords
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Article info
Publication history
Published online: January 18, 2023
Accepted:
November 18,
2022
Received in revised form:
November 10,
2022
Received:
September 20,
2021
Identification
Copyright
© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
