Growth in migration has presented health professionals with significant challenges in service delivery. First, it was assumed that in the past, due to limited migration, the majority of people attending health care services (including psychological services) in a
particular country were mostly familiar members of the population. Familiarity with the population provided health care workers with predictability and certainty in
communicating and understanding of the issues brought before them. Second, it was also assumed that better communication and understanding of the issues enhanced their quality of their service delivery. However, growth in migration has resulted in the introduction of languages, cultures, beliefs, values, and attitudes unfamiliar to most health professionals in the mainstream culture. New languages, cultural values, beliefs and attitudes have
provided health care workers with a new frontier of challenges specifically in communication, assessment, and intervention.
Apart from the socio-linguistic challenges presented by the new arrivals, researchers have identified the migration process as a stressful life event that could be associated with “culture shock” [emphasis in original article] and requires personal, economic, social, and cultural changes (Ward, Bochner, & Furnham, 2001). Evidence in literature suggests that after migrating to a new country, immigrants often find coping and the process of
adjustment required to rebuild their lives difficult and complex (Markovizky & Samid, 2008).
Other than the migration process itself, some acculturation studies have reported that length of stay in a new country was a significant factor in psychological and social acculturation. For instance, a study by Markovizky and Samid (2008) found a positive correlation was found between length of residence, satisfaction, and social contacts. Growth of multiculturalism due to immigration, has also led researchers to postulate that immigration and the differential life experiences associated with race may critically affect
the balance between physical and psychological well-being (Kutner, Bliwise, & Zhang, 2004).
However, migration, particularly the experience of migrants moving to a socio-cultural environment different from their own has provided researchers with an opportunity to study the effects of fundamental processes of adaptation (Rogler, Cortes, & Malgady, 1991) on health. Rogler and colleagues (1991) reported that the process of migration disrupted attachments to supportive networks in the society of origin. They also found that migration imposed on the immigrant populations the difficult task of integration into the primary groups of the host society. Other researchers found inconsistencies in the course of psychological adjustment arguing that immigrants‟ differences of distress patterns depended on age; thus, among the middle-aged immigrants, length of residence was positively associated with distress (Ponizovsky, Ritsner, & Modai, 2000).
Furthermore, intercontinental migration has provided sleep researchers with an opportunity to access samples of diverse ethnic participants, the same opportunity that was taken advantage of in the present study. For example, Owens (2004) commented that diversity of samples provided researchers with an opportunity to better understand the neurobiology and chronobiology of sleep from a multicultural perspective.
Despite the opportunities created by the migration process, empirical data on the contribution of migration demands on psychological distress, particularly sleep, remain rather sparse. A few studies reviewed in the present study have all reported inconsistent findings possibly due to their differences in focus. Some of the studies focused more on psychological health and acculturation (e.g., Knipscheer & Kleber, 2007) while a few
others focused on the effects of migration on the sleep of immigrant populations (e.g., Voss & Tuin, 2008b).
One study investigated sleep quality, coping styles and level of integration in a sample of Portuguese (n=48) and Moroccan (n = 64) immigrants in Germany. In this study, Voss and Tuin (2008a) found that sleep quality was poor in 54% of Portuguese and 39% of
Moroccan women which exceeded reports of sleep complaints in epidemiologic studies of sleep quality in Germany. The researchers also reported that poor sleep was attributed to higher degree of adoption of German lifestyle and high monitoring (information seeking) in the Portuguese participants compared to the Moroccan sample. Based on this finding, Voss and Tuin (2008a) concluded that non-integration into the mainstream culture may be less stressful than integration, suggesting better psychological health for those that were not integrated into the mainstream groups.
Congruent with the findings by Voss and Tuin (2008a), a study of acculturation and mental health among Ghanaians in the Netherlands, Knipscheer & Kleber (2007) found that the impact of acculturation (in particular traditional affiliation and feelings of loss) on mental health was substantial. They wrote:
It is not surprising that life transitions involved in migration and the often confounded factors of ethnicity, acculturation, and sociodemographic positions affect psychological functioning and mental health.(p. 370)
In addition, Knipscheer & Kleber (2007) concluded that a subtle balance between holding on to supportive and identity enhancing traditions and moderate involvement in ruminating about pre-migration life, in conjunction with acquiring the instrumental skills of the host culture was a starting position for better health.
In a study designed to investigate sleep and mood disturbances in recent immigrants to Australia from Yugoslavia (N = 164), Pavasovic and Kennedy (2005) found that immigrant sleep was more significantly disturbed due to frequency of nightmares compared to the general Australian population. In addition, they found that immigrants had shorter sleep durations, significantly less efficient sleep, poorer overall sleep quality, and rated feelings of tension/anxiety higher than the general Australian population (Pavasovic & Kennedy, 2005). Apart from this unpublished study, extensive literature search on databases such as Psycinfo, Scopus, and Medline using key words sleep, migration, and ethnicity returned no published studies comparing sleep of immigrants in Australia. It is this gap in knowledge about sleep of immigrant minority groups that the present study sought investigate.