Anxiety symptoms and sleep disturbance among Afghan female school students: A survey study

Background: Anxiety is one of the most common psychological disorders among school-aged children and adolescents. The main objectives of the present study were to determine the prevalence of anxiety symptoms and sleep disturbance and their association with academic performance among female school students in Herat, Afghanistan. Methods: A cross-sectional survey study was carried out among 737 female students (mean age 11.8 years) in Grades 1 to 6 of public schools in Herat. The Depression Anxiety Stress Scale for Youth (DASS-Y) and Pittsburgh Sleep Quality Index (PSQI) were to assess anxiety and sleep disturbance. Academic achievement ratings were provided by the participants’ schoolteachers Results: Based on the DASS-Y and PSQI, 65.5% reported anxiety symptoms while 46.4% reported sleep disturbance. Low academic performance (class grading) had statistically significant correlation with presence of anxiety ( r = 0.228) and sleep disturbance or poor-quality sleep ( r = 0.161). Multiple logistic regression analysis was run to see which variables predicted anxiety and sleep disturbance. The significant predictors of anxiety symptoms were being aged 13–16 years, having a lower-class performance or grade, having low economic status, and having unemployed parents. The significant predictors of sleep disturbance were being aged 13–16 years, having a lower-class grade, having an uneducated father, having low economic status, and having unemployed parents. Conclusion: There is a high prevalence of anxiety symptoms and sleep disturbance among female school students in Herat, Afghanistan. Both are associated with poorer school performance. Anxiety and sleep disturbance among Afghan female school students could be improved by changing current government policies and lifting the ban on female education in Afghanistan, campaigns on sleep education, and courses in time management.