Sleep difficulties among South Sudanese former refugees settled in Australia

Abstract

This quantitative study investigated self-reported sleep, mental health and trauma related nocturnal behaviours among South Sudanese Australians (SSA), examined sex differences in their responses, and sought to determine risk factors for insomnia in this population. Comparisons were also made to a general Australian (AUS) sample of 1,512 respondents, obtained in a previously published study using the same questions regarding sleep difficulties. Self-reports of sleep difficulties, psychological distress (Kessler Psychological Distress Scale, K10), and nocturnal post-traumatic stress symptoms (Pittsburgh Sleep Questionnaire Inventory-Addendum, PSQI-A) were obtained from 117 former refugees (aged 16–60 years) who had been resettled for a decade on average. A key finding was that SSA men (n = 62) reported many more problems compared to both SSA women and AUS men. These problems included high rates of clinical insomnia (32%), clinical-level nocturnal post-trauma symptoms (57%), restless legs (31%), daytime sleepiness (40%), fatigue (43%), and waking unrefreshed (55%). Nearly one in five SSA men had “very high psychological distress,” a rate 10 times higher than that of men in Victoria and twice as high as SSA women. Analyses suggest that for many SSA men memories and dreams of past traumas may be affecting sleep health, with some improvement over time. It was concluded that men within the South Sudanese Australian community report hitherto unrecognised significant problems with their sleep. The findings are consistent with the interpretation that unresolved pre-migration trauma stress may be affecting the sleep of about half of the South Sudanese men in Australia.

Effectiveness and cost-effectiveness of a transdiagnostic intervention for alcohol misuse and psychological distress in humanitarian settings: study protocol for a randomised controlled trial in Uganda

“…Measured on a scale of 0 to 7 Mean score Validated in a multisite international study covering Australia, Brazil, India, Thailand, UK, USA, and Zimbabwe [ 29 ]. It has also previously been validated in Rhino settlement ( https://www.elrha.org/project/improving-the-mental-health-of-refugee-men-through-guided-self-help-a-scalable-intervention-for-a-critical-link-in-humanitarian-programming/ , Paper forthcoming) K10 [ 24 ] Ten-item scale on non-specific psychological distress, scored on a scale of 1 to 5 Mean score Validated amongst South Sudanese refugees [ 41 ], and in Rhino settlement ( https://www.elrha.org/project/improving-the-mental-health-of-refugee-men-through-guided-self-help-a-scalable-intervention-for-a-critical-link-in-humanitarian-programming/ ) PHQ-9 [ 30 ] Nine-item questionnaire on prevalence of depressive symptoms assessed on a scale of 0 to 3 Mean score Validated amongst South Sudanese refugees and in northern Uganda [ 42 ] HSCL-A [ 31 ] Ten-item questionnaire on prevalence of anxiety symptoms, assessed on a scale of 1 to 4 Mean score Previously validated in multiple low and middle income settings, including Uganda [ 43 ] PCL-6 [ 44 ] Six-item measure on prevalence of PTSD, assessed on a scale of 1 to 5 Mean score Good psychometric properties amongst female South Sudanese refugees in Rhino settlement [ 45 ] WHODAS 2.0 [ 33 ] Twelve-item measure of health and disability, which covers the domains of cognition, mobility, self-care, getting along, life activities and participation in the last 30 days. It is assessed on a scale of 1 to 4 Mean score Good psychometric properties amongst female South Sudanese refugees in Rhino settlement [ 45 ] …”

Gender and Place of Settlement as Predictors of Perceived Social Support, PTSD, and Insomnia among Internally Displaced Adolescents in North-East Nigeria

“…However, studies on insomnia in internally displaced persons are limited, especially among the adolescent group, which constitutes over 60% of all IDPs in north-eastern Nigeria (IOM 2021). The few existing studies from Russia, North Korea, and Australia have reported a high prevalence in displaced populations, with incidence of 44% (Basishvili et al 2012), 38% , and 32% (Bruck et al 2020). Therefore, there is a clear need to study insomnia as an independent disorder within internally displaced adolescents (IDAs) in Nigeria.…”

Insomnia and post-migration stress among resettled Syrian refugees: a cross-sectional survey

“…The prevalence of insomnia or sleep disturbances appears to be considerably higher for refugees than among the general population (Bruck et al, 2021;Lee et al, 2016;Molsa et al, 2014). Although in the general population, women are more likely to report insomnia than men (Suh et al, 2018), this does not appear to be the case for refugees (Bruck et al, 2021;Mangrio et al, 2020). Prevalence estimates may also vary by migrant group, settlement country and resettlement time, as well as by definition of, and way of measuring, insomnia.…”

“…Pre-migration trauma is strongly associated with insomnia among refugees (Basishvili et al , 2012; Bruck et al , 2021). Insomnia is, in turn, linked to higher levels of mental health problems, chronic pain and poorer self-perceived health (Al-Smadi et al , 2019; Bruck et al , 2021; Lies et al , 2019, 2021; Mangrio et al , 2020; Park et al , 2019). Furthermore, it is also a common symptom of post-traumatic stress disorder (PTSD) (Sandahl et al , 2017).…”