Targeting sleep problems to address mental health issues in post-disaster communities: Mental health consequences in the aftermath of Typhoon Haiyan

Abstract

Background: We examined sleep disturbances and their relation with posttraumatic stress (PTS) and general psychological distress among survivors of Super Typhoon Haiyan, which made landfall in the Philippines 2013. Objectives: The study was conducted to ascertain the relationship between sleep disturbances among survivors and mental health consequences in post-disaster community setting. Methods: Sleep disturbances were hypothesized to be associated with PTS and GPD in two separate samples of respondents using Kessler-6 (K6), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and PTSD Checklist (PCL) measures. Sample 1 (n = 223) was surveyed for insomnia 18 months after the storm; Sample 2 (n = 138) was surveyed 30 months after the storm. Results: Results from structural equation modeling indicated that insomnia was associated with both PTS and GPD (Sample 1). Poor sleep quality was associated with PTS but not with GPD (Sample 2). Agenda and Intended Audience: These findings underscore the longer-term relationship between sleep disturbances and overall sleep quality to PTS in the context of a natural disaster. In many countries, the stigma of mental health problems hinders effective population-based interventions. Public health programs addressing sleep disturbances might be able to bypass resistance to psycho-social interventions, since sleep-related problems are common for many conditions. Intended Outcomes: Generating more evidence on the relationships between sleep-related indices and long-term mental health problems potentially can lend empirical support to sleep-focused interventions in postdisaster settings. In resource-challenged communities dealing with post-disaster public mental health problems, sleep-focused interventions can optimize existing health programs. Rather than adding a new layer of mental health programs requiring expansion in terms of requisite mental health professionals, resources could better be used to strengthen health programs that address issues of sleep problems. These could include lifestyle modification and community-based activities that are more accessible and culturally-sensitive to affected communities.