Mapping of the network connection between sleep quality symptoms, depression, generalized anxiety, and burnout in the general population of Peru and El Salvador.

BACKGROUND: A meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout. OBJECTIVE: The current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes. METHODS: A total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item. RESULTS: The results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador. CONCLUSION: The networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptom-based analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms.

Cross-cultural validation of the Jenkins Sleep Scale in Spanish-speaking countries.

The study aimed to validate the Jenkins Sleep Scale (JSS-4) in six Spanish-Speaking countries. A total of 1726 people participated and were distributed between men (32.4%) and women (67.6%). Confirmatory factor analysis confirmed the unidimensional structure and high reliability of the JSS-4 overall (α = 0.85, ω = 0.81) and within each country. The invariance analysis revealed that JSS-4 exhibited complete invariance across countries, thus establishing a robust foundation for inter-group comparisons. Interestingly, a comparative analysis revealed significant differences in the average levels of sleep difficulties, with particularly high rates in Spain and Chile. Item Response Theory (IRT) showed sufficient discrimination parameters for all items, and a correlation of 0.998 between Confirmatory Factor Analysis (CFA) and IRT highlighted the robustness and reliability of the results obtained. In summary, JSS-4 exhibits strong evidence of validity and consistency in measurement invariance across the six countries.