Fatores relacionados à autopercepção negativa da qualidade do sono na população indígena atendida em ambulatório de Média e alta complexidade no município de Passo Fundo – RS

Abstract

Introduction: Sleep quality is a fundamental component of health, exerting both direct and indirect influences on a wide range of physical, mental, and social outcomes. Among Indigenous populations, this dimension is particularly relevant due to historical conditions of vulnerability, ongoing transformations in traditional ways of life, the influence of social determinants of health, and persistent inequities in access to healthcare services. Despite its importance, studies investigating self-perceived sleep quality in relation to sociodemographic, behavioural, clinical, and psychosocial factors among Indigenous populations remain scarce, particularly in southern Brazil. Objectives: To analyse the sociodemographic, clinical, behavioural, and psychosocial factors associated with negative self-perceived sleep quality among an Indigenous population receiving care at a medium- and high-complexity outpatient clinic in Passo Fundo, Rio Grande do Sul, Brazil. Methods: This observational cross-sectional study adopted a descriptive and exploratory approach and was conducted at the Indigenous Outpatient Clinic of the Federal University of Fronteira Sul/Hospital São Vicente de Paulo, located in Passo Fundo, Rio Grande do Sul, Brazil. The study represents a subset of a broader research project, using data collected between April 2025 and April 2026. A convenience sample included Indigenous adults aged ≥18 years who had been referred by Primary Healthcare Units serving villages within the Passo Fundo Base Pole (DSEI Interior Sul) and who provided informed consent to participate. The dependent variable was self-perceived sleep quality, dichotomised into positive and negative sleep perception. Independent variables included sociodemographic characteristics (age, sex, ethnicity, educational attainment, income, marital status, and alcohol consumption), living conditions (place of residence, household size, and income), self-perceived physical health, mental health, and dietary quality, as well as self-reported physician-diagnosed medical conditions. Data were collected through structured interviews and analysed using descriptive statistics and tests of association, adopting a significance level of 5% and complying with all applicable ethical standards. Results: A high prevalence of negative self-perceived sleep quality was observed among participants (33.0%; 95% CI: 26.3%–39.7%). Negative sleep perception was significantly more frequent among individuals aged 30–39 years (53.0%; p=0.040), those belonging to non- Kaingang ethnic groups (66.7%; p=0.010), participants reporting negative perceptions of their diet (46.9%; p=0.004) and overall health (45.5%; p<0.001), those experiencing stress (62.8%; p<0.001), anxiety (46.2%; p=0.018), and depression (65.2%; p<0.001), and individuals with a physician-diagnosed history of obesity (46.5%; p=0.032). These findings reinforce the multifactorial nature of sleep quality and its close relationship with the health–disease process in socially vulnerable settings, highlighting that sleep should not be viewed as an isolated phenomenon but rather as an integrated component of the clinical, psychosocial, cultural, and territorial dimensions that shape Indigenous peoples' lives. The high prevalence of negative sleep perception underscores the need to strengthen attention to sleep health within clinical practice and specialised healthcare services, emphasising the importance of intercultural approaches that value traditional knowledge and promote comprehensive care. Final Considerations: Self-perceived sleep quality represents an important health indicator in the Indigenous population studied. The systematic incorporation of sleep assessment into Indigenous healthcare services may facilitate the early identification of health problems, support the planning of culturally sensitive care strategies, and contribute to reducing health inequities. Further longitudinal and qualitative studies are recommended to improve understanding of the determinants of sleep and their implications for Indigenous health.