Characterizing sleep–wake patterns in mothers and children in an agrarian community: results from the Ghana Randomized Air Pollution and Health Study

Abstract Study Objectives Several studies have examined sleep patterns in rural/indigenous communities, however little is known about sleep characteristics in women of reproductive age, and children within these populations. We investigate sleep–wake patterns in mothers and children (ages 3–5 years) leveraging data from the Ghana Randomized Air Pollution and Health Study (GRAPHS). Methods The GRAPHS cohort comprises of rural/agrarian communities in Ghana and collected multiday actigraphy in a subset of women and children to assess objective sleep–wake patterns. Data were scored using the Cole–Kripke and Sadeh algorithms for mothers/children. We report descriptive, baseline characteristics and objective sleep measures, compared by access to electricity/poverty status. Results We analyzed data for 58 mothers (mean age 33 ± 6.6) and 64 children (mean age 4 ± 0.4). For mothers, mean bedtime was 9:40 pm ± 56 min, risetime 5:46 am ± 40 min, and total sleep time (TST) was 6.3 h ± 46 min. For children, median bedtime was 8:07 pm (interquartile range [IQR]: 7:50,8:43), risetime 6:09 am (IQR: 5:50,6:37), and mean 24-h TST 10.44 h ± 78 min. Children with access to electricity had a reduced TST compared to those without electricity (p = 0.02). Mean bedtime was later for both mothers (p = 0.05) and children (p = 0.08) classified as poor. Conclusions Mothers in our cohort demonstrated a shorter TST, and earlier bed/risetimes compared to adults in postindustrialized nations. In contrast, children had a higher TST compared to children in postindustrialized nations, also with earlier sleep-onset and offset times. Investigating objective sleep–wake patterns in rural/indigenous communities can highlight important differences in sleep health related to sex, race/ethnicity, and socioeconomic status, and help estimate the impact of industrialization on sleep in developed countries.