An insight of sleep disorders in Africa

Abstract

Sleep is a recurrent physiologic and fundamental process in every human being, regardless of ethnicity, gender, birthplace, or occupation; however, the features of sleep are swayed by genetic background and environmental influences. All these factors have an intricate relationship, and arise from a complex and assorted genetic repertoire in the alleles that promote a higher genetic variation in human populations. Sleep disorders have become an uprising public health problem in the modern society; in addition, the correlation between sleep disorders and the development of late chronic diseases has been extensively studied, finding an important causality between them. Therefore, an adequate evaluation of the current situation in a developing continent such as Africa is essential to develop satisfactory health policies. In this review, we will reprise several aspects that influence the sleep-wake cycle in individuals with African heritage (including African Americans and sub-Saharan Africans), such as genetic background, HIV infection, tropical diseases, immunological markers, cultural aspects, and place them into Africa's context in order to have a better comprehension of its situation.

Keywords: African heritage; CNS, Central nervous system; CRP, C-reactive protein; CSF, Cerebrospinal fluid; Cry, Cryptochrome; HAT, Human African trypanosomiasis; IL-6, Interleukin 6; IL1R2, Interleukin 1 receptor type 2; Inflammatory markers; OSA, Obstructive sleep apnea; Obstructive sleep apnea; PER, Period; PLEK, Plekstrin; SES, Socioeconomic status; SNP, Single nucleotide polymorphism; Sleep disorders; Tropical diseases.

Fig. 1

Interactions between OSA, infectious diseases, and African genes. Obesity in an inflammatory state that results in an increase of IL-6 and CRP, both conditions increase the risk of suffering OSA. In turn, OSA induces an increase of CRP and IL-6. This derives in a positive feedback loop between OSA, CRP/IL-6, and obesity, which ultimately ends in a severe sleep and homeostatic disarray. In addition, infectious diseases like HIV and HAT also lead to an increase of pro-inflammatory cytokines that favor the development of OSA. CRP, C-reactive protein; HAT, human African trypanosomiasis; HIV, human immunodeficiency virus; OSA, obstructive sleep apnea;