Sleep Disturbance in Indonesia: How Much Does Smoking Contribute?

Objective: To examine the linkage between smoking and sleep disturbance in Indonesia Methods: This study used data from the 2014 Indonesia Family Life Survey (IFLS), drawn from a sample of 38,879 individuals from 15,067 households living in 262 communities. Sleep disturbance was measured by ten validated indicators of sleep quality and sleep deprivation adopted from the PROMIS (Patient Recorded Outcomes Measurement Information System), developed by the USC Center for Economic and Social Research (CESR), USA. Hierarchical ordered logistic regression was used to account for unobserved factors in village communities. Results: In 2014, the prevalence of smoking in Indonesia remained high at thirty-two percent of the population, or about ninety million active smokers. Nearly half of smokers were young adult males. Eight of every ten males who reported sleep disturbance were smokers. Current smokers' odds of facing sleep disturbance were almost one-and-one-half times higher than those of nonsmokers (OR = 1.39, p-value < 0.01), and among heavy smokers, the odds were almost double (OR = 1.91, p-value < 0.01). These findings were controlled for stressors, chronic diseases, social support and sociodemographic characteristics as well as unobserved factors in village communities. Conclusion: The substantial relationship between smoking and sleep disturbance suggests that policies that address the issue of sleep disturbance through preventing tobacco use among young adults should be a public health priority in Indonesia.