Sleep quality and its associated factors among women of reproductive age in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Quality sleep is vital for women's health during reproductive years, affecting both physical and mental well-being. In Ethiopia, socio-economic and cultural factors worsen sleep issues, but data on this demographic are scarce. This systematic review and meta-analysis assesses the prevalence of poor sleep quality among Ethiopian women and identifies contributing factors, aiming to inform interventions and policies to improve sleep health in low-resource settings. Method: This systematic review followed PRISMA guidelines and searched PubMed, Scopus, and Web of Science for observational studies. We included studies utilizing the Pittsburgh Sleep Quality Index (PSQI), as it is the most widely validated tool for assessing subjective sleep quality across diverse populations. Reviewers independently screened articles using Rayyan and assessed study quality with the Joanna Briggs Institute tools. Data were analyzed using Stata version 17. To account for potential clinical and methodological variability across studies, a random-effects model was employed to pool results, with heterogeneity assessed using statistics and the Cochrane's Q test. Publication bias and sensitivity analyses were also performed. Result: Nine studies involving 4,376 women of reproductive age (15-49 years) in Ethiopia were included. The pooled prevalence of poor sleep quality was 49.17% (95% CI: 35.29, 63.08). Significant predictors of poor sleep quality included intimate partner violence (OR: 3.24), depression (OR: 3.37), unplanned pregnancy (OR: 2.71), multigravidity (OR: 2.61), and substance use (OR: 2.24). Conclusion: A systematic review indicates that nearly half of Ethiopian women of reproductive age experience poor sleep quality. Key factors include unplanned pregnancies, substance use history, intimate partner violence, previous depression, stress, being in the third trimester, and comorbidities; these need urgent attention and the implementation of screening and preventive measures. Future research should focus on effective interventions to improve sleep quality in these populations. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023455867.