The need to study the role of sleep in climate change adaptation, mitigation, and resiliency strategies across the life course

A systematic review of ambient heat and sleep in a warming climate

Climate change is elevating nighttime and daytime temperatures worldwide, affecting a broad continuum of behavioral and health outcomes. Disturbed sleep is a plausible pathway linking rising ambient temperatures with several observed adverse human responses shown to increase during hot weather. This systematic review aims to provide a comprehensive overview of the literature investigating the relationship between ambient temperature and valid sleep outcomes measured in real-world settings, globally. We show that higher outdoor or indoor temperatures are generally associated with degraded sleep quality and quantity worldwide. The negative effect of heat persists across sleep measures, and is stronger during the hottest months and days, in vulnerable populations, and the warmest regions. Although we identify opportunities to strengthen the state of the science, limited evidence of fast sleep adaptation to heat suggests rising temperatures induced by climate change and urbanization pose a planetary threat to human sleep, and therefore health, performance, and wellbeing.

Addressing sleep deserts: A proposed call for action

Sleep deserts are a major cause of health inequity. They occur primarily in disadvantaged neighborhoods because of structural racism, social and environmental factors, and dearth of medical services. We describe several strategies that can serve as a feasible action plan to target structural racism, environmental pollution, and impact of climate change. We also suggest ways healthcare providers in these underserved areas can incorporate sleep medicine into their practice. Lastly, we highlight strategies to increase community awareness of sleep health in a culturally sensitive manner. There are several ways, from a policy level to healthcare that we can begin to eliminate sleep deserts, which is urgently needed.

Association of extreme heat events with sleep and cardiovascular health: A scoping review

BACKGROUND

Extreme heat events (EHEs), driven by anthropogenic climate change, exacerbate the risk of cardiovascular disease (CVD), although the underlying mechanisms are unclear. Disturbances in sleep health, caused by excessive heat, may be one way EHEs increase the risk of incident or recurrent CVD. Our objective was to systematically review the empirical peer-reviewed literature on the relationship between EHEs, sleep health, and cardiovascular measures and outcomes, and narratively describe methodologies, evidence, and gaps in this area.

METHODS

A comprehensive literature search was performed in the following databases from inception - June 2023: Ovid MEDLINE, Ovid EMBASE, CINAHL, Web of Science and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria.

RESULTS

Of the 2035 records screened, three studies met the inclusion criteria. Cardiovascular (CV) measures described included blood pressure (BP), heart rate (HR), and HR variability (no CVD outcomes were described) and objective and subjective measurements of sleep health outcomes included sleep duration, calmness, ease of falling asleep, ease of awakening, freshness after awakening, and sleep satisfaction. Two studies were controlled trials, and one was a cohort study. During EHEs, individuals slept for shorter periods of time and less efficiently, with greater degrees of HR variability in two of the three studies lasting at most 1-2 days; BP (both systolic and diastolic) significantly decreased during EHEs in two of the studies. No formal assessment of a mediating relationship between EHE exposure, sleep outcomes, and the CV measures was undertaken.

CONCLUSIONS

There is a paucity of data that examines the link between CVD, sleep, and extreme heat as a possible mechanism of elevated CVD risk during EHEs, despite a strong physiological rationale. Further research is needed to empirically test this relationship rigorously as EHEs become more frequent and their deleterious impacts of health increase.

The influence of climate change on mental health in populations of the western Pacific region: An umbrella scoping review

The Western Pacific Region (WPR) is on the front line of climate change challenges. Understanding how these challenges affect the WPR populations' mental health is essential to design effective prevention and care policies. Thus, the present study conducted an umbrella scoping review that examined the influence of climate change on mental health in the WPR, using review articles as a source of information. Ten review articles were selected according to eligibility criteria, and the findings were synthesized according to the socio-economic status of the countries identified: Australia, the Republic of Korea, the Philippines, Vietnam, the Pacific Islands (broadly), and China. The findings revealed that each country and sub-region has its own unique profile of climate change-related challenges and vulnerable populations, highlighting the need for specific approaches to mental health care. Specifically, the influence of climate-related challenges differed according to populations' region (e.g., rural populations), demographic characteristics (e.g., age and gender), culture (e.g., traditional tights to land), and employment (e.g., farmers and fishers). The most frequently reported mental health outcomes in response to climate change-related challenges such as droughts, floods, storms, tornadoes, typhoons, and climate-related migration were the decline in mental well-being and the increase in post-traumatic stress disorder symptoms. In addition, using the GRADE framework for assessing the certainty of the findings, we identified that the number of articles discussing associations between a given climate change challenge and a mental health outcome was overall limited. Based on our findings and findings on a global scale, we identified several key research gaps in WPR and provided recommendations for future research and policy strategies.