Addressing Sleep Health in Refugee Populations: A Systematic Review of Intervention Effectiveness and Cultural Adaptation

Jaclyn Kirsch (), Christine E. Spadola, Kabir Parikh, Kristen Kerr and Hrayr Attarian
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Jaclyn Kirsch: School of Social Work, The University of Texas at Arlington, Arlington, TX 76019, USA
Christine E. Spadola: School of Social Work, The University of Texas at Arlington, Arlington, TX 76019, USA
Kabir Parikh: School of Social Work, The University of Texas at Arlington, Arlington, TX 76019, USA
Kristen Kerr: School of Social Work, The University of Texas at Arlington, Arlington, TX 76019, USA
Hrayr Attarian: Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA

Social Sciences, 2025, vol. 14, issue 8, 1-16

Abstract: Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations.

Keywords: refugees; sleep; mental health; social work; systematic review (search for similar items in EconPapers)
JEL-codes: A B N P Y80 Z00 (search for similar items in EconPapers)
Date: 2025
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