Sleep disturbance as a precursor to anxiety, depression, and PTSD among rural Kenyans: a cross-lagged panel analysis from a rural Kenyan interventional cohort

Sleep quality is essential to biopsychosocial functioning, yet there remains limited longitudinal research on sleep and mental or social well-being within low- or middle-income countries. This study utilizes longitudinal cohort data from a community-based empowerment program in Meru County, Kenya to assess cross-lagged correlations between sleep disturbance, social support, symptoms of depression, anxiety, and posttraumatic stress, Participants (n=373; 92% women; age range 18-86 years) who reported more sleep disturbance at T1 reported significantly more symptoms of depression, anxiety and PTSD, and significantly less social support at T2 (average 11 weeks later), controlling for all within-time correlations across measures, within-measure correlations across time, and sociodemographic background characteristics. Findings are consistent with research across high-income countries, underscoring the need for more contextualized research into sleep behaviors across low- and middle-income countries. Findings may inform interventions to increase mental and social well-being within Kenya.