Predictors and Mediators of Sleep Quality After Multiple Consecutive Devastating Earthquakes in Turkey

Objective:The aim of this study is to determine the prevalence of insomnia and the level of sleep quality in the first month of earthquakes in Kahramanmara and to investigate the effects of earthquake stress coping strategies on sleep quality and insomnia.Materials and Methods: This cross-sectional study included 509 adults in Adana.Sleep problems were assessed with the Insomnia Severity Index and Pittsburgh Sleep Quality Index (PSQI), and the coping level with earthquake stress with the Coping with Earthquake Stress Scale (CESS). Results:The mean age of the individuals was 29.4212.62years and 73.1% were female.After the earthquake, 64% of the participants had decreased sleep duration, 66.8% had increased night awakenings, 77.6% had difficulty falling asleep, and 7.3% started to use sleeping pills to sleep.All participants had poor sleep quality; 26.1% had moderate insomnia and 8.1% had clinical insomnia.After the earthquake, the risk of moderate and clinical insomnia was found to be increased Odds ratio (OR)=2.33times in the 18-40 age group, OR=2.07 times in females, OR=1.88 times in those with children, and OR=2.29 times in people with previous sleep disorders.The use of the positive reappraisal strategy improved sleep quality, and each unit increase in this subdimension of CESS caused a 0.137-unit decrease in the PSQI score.Coping strategies contributed to the improvement of sleep quality both directly and indirectly by reducing insomnia.Conclusion: Sleep problems were common in the subacute period after the earthquake.We recommend interventions to develop positive reappraisal strategies for groups vulnerable to sleep problems.