Meta-analysis finds poor sleep quality affects nearly half of Ethiopian women of reproductive age

Photo by Vitaly Gariev / Unsplash

Frontiers in Medicine Published May 20, 2026 Medically reviewed May 20, 2026 DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider screening for poor sleep quality among Ethiopian women of reproductive age, noting associations with violence, depression, and unplanned pregnancy.

This is a systematic review and meta-analysis of observational studies assessing poor sleep quality using the Pittsburgh Sleep Quality Index (PSQI) among women of reproductive age (15–49 years) in Ethiopia. The analysis pooled data from 9 studies involving 4,376 women.

The primary finding was a pooled prevalence of poor sleep quality of 49.17% (95% CI: 35.29, 63.08). The authors identified several factors as significant predictors of poor sleep quality, with reported odds ratios: 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).

The authors noted key limitations, including data scarcity on this demographic in Ethiopia and potential clinical and methodological variability across the included studies. The certainty of the evidence is limited by the observational nature of the included studies.

The practice relevance highlighted is that nearly half of Ethiopian women of reproductive age experience poor sleep quality, and key factors include unplanned pregnancies, substance use history, intimate partner violence, and previous depression. The authors call for urgent attention and implementation of screening and preventive measures, while noting that associations are reported as predictors and causation is not established.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundQuality 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.MethodThis 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.ResultNine 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).ConclusionA 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 Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023455867.