{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:20:26Z","timestamp":1770988826122,"version":"3.50.1"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Poor sleep quality is common during the postpartum period due to nighttime feeding and frequent nocturnal awakenings of infants. In addition, the condition may worsen among postpartum women living with human immunodeficiency virus (HIV), affecting their capacity to care for their child. Therefore, this study will provide baseline information by assessing the burden of poor sleep quality and associated factors among HIV-positive and negative postpartum women in Addis Ababa, Ethiopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to assess poor sleep quality and its associated factors among HIV-positive and negative postpartum women in Addis Ababa, Ethiopia in 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comparative cross-sectional study was conducted from 20 March to 20 May 2023, and a systematic random sampling technique was employed to obtain a total of 535 study subjects. An interviewer-administered questionnaire and chart review were used to collect the data. The Pittsburgh Sleep Quality Index was used to assess the outcome variable with a cutoff point \u22655. Binary logistic regression was employed to check the association of each independent variable with the outcome variable. Variables having a <jats:italic>p<\/jats:italic>-value of less than 0.05 in multivariable analysis were considered statistically significant and an adjusted odds ratio with a 95% confidence interval (CI) was computed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, the overall prevalence of poor sleep quality among postpartum women was 56.3% [95% CI (51.9, 60.6)]. Poor sleep quality prevalence among HIV-positive and -negative women was 80% and 50.5%, respectively. Being HIV-positive [AOR = 2.38, 95% CI (1.31, 4.32)], being divorced [AOR = 4.5, 95% CI (1.55, 13)], and having a family history of mental illness [AOR = 1.89, 95% CI (1.16, 3.1)], depression [AOR = 1.93 (1.11, 3.3)], and anxiety [AOR = 2.76, 95% CI (1.8, 4.2)] among postpartum women and poor social support [AOR = 6, 95% CI (1.63, 22.4)] among HIV-positive women were significantly associated with poor sleep quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and recommendation<\/jats:title><jats:p>This study revealed that the prevalence of poor sleep quality was higher among HIV-positive postpartum women compared to HIV-negative women. It would be better if professionals routinely assess postpartum women for sleep quality and focus on HIV-positive women.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1362384","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T06:58:35Z","timestamp":1737615515000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Poor sleep quality and associated factors among HIV-positive and negative postpartum women in Addis Ababa, Ethiopia: a comparative cross-sectional study"],"prefix":"10.3389","volume":"15","author":[{"given":"Milen","family":"Mihertabe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alehegn Bishaw","family":"Geremew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa Awoke","family":"Fentie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gidey","family":"Rtbey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"B1","volume-title":"Diagnostic and statistical manual of mental disorders: DSM-5","year":"2013"},{"key":"B2","volume-title":"Kaplan & Sadock\u2019s synopsis of psychiatry: behavioral sciences\/clinical psychiatry","author":"Sadock","year":"2015"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1111\/nuf.12659","article-title":"Sleep quality: An evolutionary concept analysis","volume-title":"Nursing forum: 2022","author":"Nelson","year":"2022"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s43076-021-00116-9","article-title":"The global prevalence of depression, anxiety, stress, and insomnia among general population during COVID-19 pandemic: A systematic review and meta-analysis","volume":"31","author":"Mahmud","year":"2023","journal-title":"Trends Psychol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.sleep.2016.03.008","article-title":"Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people","volume":"30","author":"Hinz","year":"2017","journal-title":"Sleep Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/jnu.2014.46.issue-2","article-title":"Postpartum women\u2019s sleep quality and its predictors in Taiwan","volume":"46","author":"Ko","year":"2014","journal-title":"J Nurs Scholarship"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1733933","article-title":"Leveraging American College of Obstetricians and gynecologists guidelines for Point-of-care decision support in obstetrics","volume":"12","author":"Sanford","year":"2021","journal-title":"Appl Clin Inf"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/1552-6909.12562","article-title":"A systematic review of the relationship between postpartum sleep disturbance and postpartum depression","volume":"44","author":"Bhati","year":"2015","journal-title":"J Obstetric Gynecol Neonatal Nurs"},{"key":"B9","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s00404-012-2248-z","article-title":"Factors related to insomnia and sleepiness in the late third trimester of pregnancy","volume":"286","author":"Fern\u00e1ndez-Alonso","year":"2012","journal-title":"Arch Gynecol Obstetrics"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.12.006","article-title":"Sleep patterns and sleep disturbances across pregnancy","volume":"16","author":"Mindell","year":"2015","journal-title":"Sleep Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00161","article-title":"Prevalence of poor sleep quality in perinatal and postnatal women: a comprehensive meta-analysis of observational studies","volume":"11","author":"Yang","year":"2020","journal-title":"Front Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3998\/2027.42\/163503","article-title":"Monitoring the future national survey results: HIV\/AIDS risk & Protective behaviors among adults ages 21 to 30 in the US, 2004-2018","author":"Johnston","year":"2019","journal-title":"Institute Soc Res"},{"key":"B13","first-page":"1980","volume-title":"Fact sheet\u2014latest global and regional statistics on the status of the AIDS epidemic","author":"Unaids","year":"2017"},{"key":"B14","volume-title":"AIDS statistics\u20142018 fact sheet","year":"2019"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2015.03.027","article-title":"Self-reported sleep disturbances in HIV-infected people: a meta-analysis of prevalence and moderators","volume":"16","author":"Wu","year":"2015","journal-title":"Sleep Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"16955","DOI":"10.1038\/s41598-024-68074-7","article-title":"Poor sleep quality and its associated factors among HIV\/ADIS patients living in sub-Saharan African countries: a systematic review and meta-analysis","volume":"14","author":"Melese","year":"2024","journal-title":"Sci Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/3157637","article-title":"Determinants of insomnia among mothers during postpartum period in northwest Ethiopia","author":"Belete","year":"2019","journal-title":"Sleep Disord"},{"key":"B18","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1186\/s12888-022-04173-x","article-title":"Prevalence and associated factors of poor sleep quality among postpartum women in North West Ethiopia: a community-based study","volume":"22","author":"Gessesse","year":"2022","journal-title":"BMC Psychiatry"},{"key":"B19","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1186\/s12888-022-04209-2","article-title":"Poor sleep quality and associated factors among HIV-positive pregnant women in Northwest, Ethiopia: a facility-based, cross-sectional study","volume":"22","author":"Legas","year":"2022","journal-title":"BMC Psychiatry"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2747","DOI":"10.18639\/RABM.2017.03.509325","article-title":"Predictors of sleep disorders among HIV out-patients in a tertiary hospital","volume":"3","author":"Bisong","year":"2017","journal-title":"Recent Adv Biol Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-018-9950-7","article-title":"Poor sleep quality increases symptoms of depression and anxiety in postpartum women","volume":"41","author":"Okun","year":"2018","journal-title":"J Behav Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7924","article-title":"Poor postpartum sleep quality predicts subsequent postpartum depressive symptoms in a high-risk sample","volume":"15","author":"McEvoy","year":"2019","journal-title":"J Clin Sleep Med"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2018.02.004","article-title":"Sleep quality at 3 months postpartum considering maternal age: A comparative study","volume":"31","author":"Wen","year":"2018","journal-title":"Women Birth: J Aust Coll Midwives"},{"key":"B24","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.whi.2008.07.015","article-title":"The relationship between sleep characteristics and fatigue in healthy postpartum women","volume":"19","author":"Rychnovsky","year":"2009","journal-title":"Women\u2019s Health Issues"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1819.2001.00835.x","article-title":"Comparisons of sleep patterns between mothers in post-partum from 9 to 12 weeks and non-pregnant women","volume":"55","author":"Nishihara","year":"2001","journal-title":"Psychiatry Clin Neurosci"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0233849","DOI":"10.1371\/journal.pone.0233849","article-title":"Quality of sleep and associated factors among people living with HIV\/AIDS attending ART clinic at Hawassa University comprehensive specialized Hospital, Hawassa, SNNPR, Ethiopia","volume":"15","author":"Bedaso","year":"2020","journal-title":"PloS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"3657","DOI":"10.1038\/s41598-017-03968-3","article-title":"Burden of sleep disturbances and associated risk factors: a cross-sectional survey among HIV-infected persons on antiretroviral therapy across China","volume":"7","author":"Huang","year":"2017","journal-title":"Sci Rep"},{"key":"B28","doi-asserted-by":"publisher","first-page":"100054","DOI":"10.1016\/j.sleepx.2022.100054","article-title":"Poor sleep quality and associated factors among people attending anti-retroviral treatment clinic at Finote selam general hospital, Amhara, Ethiopia","volume":"4","author":"Adane","year":"2022","journal-title":"Sleep Med: X"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.33024\/minh.v3i2.3473","article-title":"Post-caesarean section pain and quality of sleep among mothers who delivered by caesarean section under spinal anesthesia","volume":"3","author":"Harini","year":"2020","journal-title":"Malahayati Int J Nurs Health Sci"},{"key":"B30","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12955-017-0637-5","article-title":"Validation of the Pittsburgh sleep quality index in community dwelling Ethiopian adults","volume":"15","author":"Salahuddin","year":"2017","journal-title":"Health Qual Life Outcomes"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11920-019-0999-y","article-title":"Maternal sleep in pregnancy and postpartum part I: mental, physical, and interpersonal consequences","volume":"21","author":"Christian","year":"2019","journal-title":"Curr Psychiatry Rep"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.06.020","article-title":"Detecting postnatal common mental disorders in Addis Ababa, Ethiopia: validation of the Edinburgh postnatal depression scale and Kessler scales","volume":"122","author":"Tesfaye","year":"2010","journal-title":"J Affect Disord"},{"key":"B33","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1186\/s12884-019-2594-y","article-title":"Postpartum depression and associated factors among mothers who gave birth in the last twelve months in Ankesha district, Awi zone, North West Ethiopia","volume":"19","author":"Shitu","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Internal Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e0248331","DOI":"10.1371\/journal.pone.0248331","article-title":"Comorbid anxiety and depression: Prevalence and associated factors among pregnant women in Arba Minch zuria district, Gamo zone, southern Ethiopia","volume":"16","author":"Bante","year":"2021","journal-title":"PloS One"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e0233907","DOI":"10.1371\/journal.pone.0233907","article-title":"High rate of partner violence during pregnancy in eastern Ethiopia: findings from a facility-based study","volume":"15","author":"Musa","year":"2020","journal-title":"PloS One"},{"key":"B37","first-page":"32","article-title":"Psychometric properties of the 3-item oslo social support scale among clinical students of Bayero University Kano, Nigeria","volume":"22","author":"Abiola","year":"2013","journal-title":"Malaysian J Psychiatry"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00185.x","article-title":"The alcohol, smoking and substance involvement screening test (ASSIST): development, reliability and feasibility","volume":"97","year":"2002","journal-title":"Addiction"},{"key":"B39","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1177\/1054773803259655","article-title":"Physiological and psychological correlates of sleep in HIV infection","volume":"13","author":"Robbins","year":"2004","journal-title":"Clin Nurs Res"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.03.003","article-title":"Sleepiness and sleep quality in patients with HIV infection","volume":"72","author":"Wibbeler","year":"2012","journal-title":"J Psychosomatic Res"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/32.7.847","article-title":"Sleep and depression in postpartum women: a population-based study","volume":"32","author":"D\u00f8rheim","year":"2009","journal-title":"Sleep"},{"key":"B42","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1111\/j.1547-5069.2009.01326.x","article-title":"A comparative study of sleep quality between pregnant and nonpregnant Taiwanese women","volume":"42","author":"Ko","year":"2010","journal-title":"J Nurs Scholarship"},{"key":"B43","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.sleh.2019.07.008","article-title":"Association between sleep quality and physical activity in postpartum women","volume":"5","author":"Wu","year":"2019","journal-title":"Sleep Health"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S297964","article-title":"Association between recent experience of childbirth and sleep quality in South Korean women: results from a nationwide study","volume":"13","author":"Kim","year":"2021","journal-title":"Nat Sci Sleep"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e0226562","DOI":"10.1371\/journal.pone.0226562","article-title":"Association between depressive symptoms and poor sleep quality among Han and Manchu ethnicities in a large, rural, Chinese population","volume":"14","author":"Liu","year":"2019","journal-title":"PloS One"},{"key":"B46","doi-asserted-by":"publisher","first-page":"16","DOI":"10.4236\/ijcm.2019.101003","article-title":"Quality of sleep among pregnant women","volume":"10","author":"Huong","year":"2019","journal-title":"Int J Clin Med"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis192","article-title":"Prevalence and factors associated with sleep disturbances among early-treated HIV-infected persons","volume":"54","author":"Crum-Cianflone","year":"2012","journal-title":"Clin Infect Dis: An Off Publ Infect Dis Soc America"},{"key":"B48","doi-asserted-by":"publisher","first-page":"6","DOI":"10.22038\/ijogi.2018.10577","article-title":"Evaluation of postpartum sleep quality and the influential factors in the women in Zanjan city, Iran (2014)","volume":"21","author":"Behboodi Moghadam","year":"2018","journal-title":"Iranian J Obstetrics Gynecol Infertility"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S259072","article-title":"How the sleep of couples changes from pregnancy to three months postpartum","volume":"13","author":"Cattarius","year":"2021","journal-title":"Nat Sci Sleep"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1089\/whr.2023.0024","article-title":"Cultural beliefs and traditional practices during pregnancy, child birth, and the postpartum period in East Gojjam Zone, Northwest Ethiopia: a qualitative study","volume":"4","author":"Aynalem","year":"2023","journal-title":"Women\u2019s Health Rep"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2006.12.010","article-title":"A population-based survey of women\u2019s traditional postpartum behaviours in Northern China","volume":"24","author":"Wang","year":"2008","journal-title":"Midwifery"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-022-08364-0","article-title":"Characterization of basal ganglia volume changes in the context of HIV and polysubstance use","volume":"12","author":"Monick","year":"2022","journal-title":"Sci Rep"},{"key":"B53","doi-asserted-by":"publisher","first-page":"632","DOI":"10.2741\/s176","article-title":"Sleep and innate immunity","volume":"3","author":"Zielinski","year":"2011","journal-title":"Front Biosci (Scholar Edition)"},{"key":"B54","first-page":"76","article-title":"Comparison the depression, anxiety and stress in intravenous drug abusers, with and without HIV\/AIDS","volume":"20","author":"Khalatbari","year":"2011","journal-title":"J Guilan Univ Med Sci"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1177\/0886260514567961","article-title":"Subjective sleep quality in women with divorce histories: The role of intimate partner victimization","volume":"31","author":"Newton","year":"2016","journal-title":"J Interpersonal Violence"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2014.03.006","article-title":"A meta-analysis and model of the relationship between sleep and depression in adolescents: recommendations for future research and clinical practice","volume":"18","author":"Lovato","year":"2014","journal-title":"Sleep Med Rev"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.26699\/jnk.v10i1.ART.p144-153","article-title":"Systematic review: the relationship of spouses\u2019 support and postpartum depression. Jurnal Ners dan Kebidanan","volume":"10","author":"Agatra","year":"2023","journal-title":"Journal of Ners and Midwifery"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daac049","article-title":"The impact of caring for family members with mental illnesses on the caregiver: a scoping review","volume":"38","author":"Phillips","year":"2022","journal-title":"Health Promotion Int"},{"key":"B59","doi-asserted-by":"publisher","first-page":"e056564","DOI":"10.1136\/bmjopen-2021-056564","article-title":"Sleep quality and associated factors among pregnant women attending antenatal care unit at Gondar, Ethiopia: a cross-sectional study","volume":"12","author":"Takelle","year":"2022","journal-title":"BMJ Open"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-955136\/v1","article-title":"Predictors of Poor Quality of Life among People Living with HIV\/AIDS on Antiretroviral therapy in Jimma zone Public Hospitals, South West Ethiopia: A Mixed-method Study","volume":"4","author":"Gesese","year":"2021","journal-title":"J Psychol Psychother."},{"key":"B61","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12888-023-04619-w","article-title":"Sleep quality and associated factors among adult people living with HIV on follow-up at Dessie Town Governmental Health Facilities Antiretroviral Therapy Clinics, Northeast, Ethiopia, 2020, a multicenter cross-sectional study","volume":"23","author":"GebreEyesus","year":"2023","journal-title":"BMC Psychiatry"},{"key":"B62","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.eurpsy.2019.05.004","article-title":"The bidirectional causal relationships of insomnia with five major psychiatric disorders: a Mendelian randomization study","volume":"60","author":"Gao","year":"2019","journal-title":"Eur Psychiatry"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2024.1362384\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T06:58:39Z","timestamp":1737615519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2024.1362384\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,23]]},"references-count":62,"alternative-id":["10.3389\/fpsyt.2024.1362384"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2024.1362384","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,23]]},"article-number":"1362384"}}