Network analysis of sleep quality symptoms in individuals from four spanish-speaking countries in Latin America and Europe

Introduction/objective: Identifying sleep quality patterns is crucial for health authorities in order to understand their detrimental impacts and develop appropriate preventive strategies. This study aimed to analyse sleep quality symptoms using network analysis in individuals from four Spanish- speaking countries in Latin America and Europe. Method: A total of 1,899 participants from Peru, El Salvador, Honduras, and Spain took part in the study. A non-probabilistic snowball sampling method was employed and the Jenkins Sleep Scale was used to assess sleep quality symptoms. The bootnet package in RStudio was used to estimate a general network, and the node centrality was calculated using the Strength index. The networks were compared across countries using the NetworkComparisonTest package. Results: The results indicated that difficulty staying asleep was the most central symptom, meaning that it was the most relevant symptom within the sleep quality network when considering the overall sample from all evaluated countries. However, a more specific analysis revealed that in Spain and El Salvador, the most central symptom was “difficulty staying asleep,” while in Peru and Honduras, the most central symptom was “difficulty falling asleep.” Additionally, network comparisons by country showed that at a general level, the sleep quality symptom networks of the four countries were invariant. Conclusion: The findings of this study may serve as a starting point to better understand the associations between sleep quality symptoms based on network analysis in Spanish-speaking countries.