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Gabet S, Levasseur A, Thierry B, Wasfi R, Kestens Y, Moullec G, Simonelli G. Household and housing determinants of sleep duration during the COVID-19 pandemic: Results from the COHESION Study. Sleep Health 2024:S2352-7218(24)00115-3. [PMID: 39003102 DOI: 10.1016/j.sleh.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/15/2024] [Accepted: 05/26/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Public health measures in response to the COVID-19 pandemic forced individuals to spend more time at home. We sought to investigate the relationship between housing characteristics and sleep duration in the context of COVID-19. METHODS Our exploratory study was part of the COvid-19: Health and Social Inequities across Neighborhoods (COHESION) Study Phase-1, a pan-Canadian population-based cohort involving nearly 1300 participants, launched in May 2020. Sociodemographic, household and housing characteristics (dwelling type, dissatisfaction, access to outdoor space, family composition, etc.), and self-reported sleep were prospectively collected through COHESION Study follow-ups. We explored the associations between housing and household characteristics and sleep duration using linear regressions, as well as testing for effect modification by income satisfaction and gender. RESULTS Our study sample involved 624 COHESION Study participants aged 50 ± 16years (mean±SD), mainly women (78%), White (86%), and university graduates (64%). The average sleep duration was 7.8 (1.4) hours. Sleep duration was shorter according to the number of children in the household, income dissatisfaction, and type of dwelling in multivariable models. Sleep was short in those without access to a private outdoor space, or only having a balcony/terrace. In stratified analyses, sleep duration was associated with housing conditions dissatisfaction only in those dissatisfied with their income. CONCLUSION Our exploratory study highlights the relationship between housing quality and access to outdoor space, family composition and sleep duration in the context of COVID-19. Our findings also highlight the importance of housing characteristics as sources of observed differences in sleep duration.
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Affiliation(s)
- Stephan Gabet
- Département de Médecine Sociale et Préventive, École de Santé publique de l'Université de Montréal (ESPUM), Montréal, Quebec, Canada; Centre de Recherche en Santé Publique (CReSP), Université de Montréal (UdeM), Montréal, Quebec, Canada; Université de Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483-IMPacts de l'Environnement Chimique sur la Santé (IMPECS), Lille, France
| | - Anthony Levasseur
- Département de Médecine, Université de Montréal (UdeM), Montréal, Québec, Canada; Center for Advanced Research in Sleep Medicine (CEAMS), Centre de Recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Québec, Quebec, Canada
| | - Benoit Thierry
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal (UdeM), Montréal, Quebec, Canada
| | - Rania Wasfi
- Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada/Government of Canada, Ottawa, Ontario, Canada
| | - Yan Kestens
- Département de Médecine Sociale et Préventive, École de Santé publique de l'Université de Montréal (ESPUM), Montréal, Quebec, Canada; Centre de Recherche en Santé Publique (CReSP), Université de Montréal (UdeM), Montréal, Quebec, Canada
| | - Grégory Moullec
- Département de Médecine Sociale et Préventive, École de Santé publique de l'Université de Montréal (ESPUM), Montréal, Quebec, Canada; Center for Advanced Research in Sleep Medicine (CEAMS), Centre de Recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Québec, Quebec, Canada
| | - Guido Simonelli
- Département de Médecine, Université de Montréal (UdeM), Montréal, Québec, Canada; Center for Advanced Research in Sleep Medicine (CEAMS), Centre de Recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Québec, Quebec, Canada; Département de Neurosciences, Université de Montréal (UdeM), Montréal, Québec, Canada.
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Ghani SB, Granados K, Wills CCA, Alfonso-Miller P, Buxton OM, Ruiz JM, Parthasarathy S, Patel SR, Molina P, Seixas A, Jean-Louis G, Grandner MA. Association of Birthplace for Sleep Duration, Sleep Quality, and Sleep Disorder Symptoms, at the US-Mexico Border. Behav Sleep Med 2024; 22:393-409. [PMID: 37968911 PMCID: PMC11093882 DOI: 10.1080/15402002.2023.2279308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The present study investigated the roles birthplace and acculturation play in sleep estimates among Hispanic/Latino population at the US-Mexico border. MEASURES Data were collected in 2016, from N = 100 adults of Mexican descent from the city of Nogales, AZ, at the US-Mexico border. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index categorized as none, mild, moderate, and severe, and Multivariable Apnea Prediction Index (MAP) categorized as never, infrequently, and frequently. Acculturation was measured with the Acculturation Rating Scale for Mexican-Americans II (ARSMA-II). RESULTS The sample consisted of majority Mexican-born (66%, vs. born in the USA 38.2%). Being born in the USA was associated with 55 fewer minutes of nighttime sleep (p = .011), and 1.65 greater PSQI score (p = .031). Compared to no symptoms, being born in the USA was associated with greater likelihood of severe difficulty falling asleep (OR = 8.3, p = .030) and severe difficulty staying asleep (OR = 11.2, p = .050), as well as decreased likelihood of breathing pauses during sleep (OR = 0.18, P = .020). These relationships remained significant after Mexican acculturation was entered in these models. However, greater Anglo acculturation appears to mediate one fewer hour of sleep per night, poorer sleep quality, and reporting of severe difficulty falling asleep and staying asleep. CONCLUSIONS Among individuals of Mexican descent, being born in the USA (vs Mexico) is associated with about 1 hour less sleep per night, worse sleep quality, more insomnia symptoms, and less mild sleep apnea symptoms. These relationships are influenced by acculturation, primarily the degree of Anglo rather than the degree of Mexican acculturation.
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Affiliation(s)
- Sadia B Ghani
- Department of Psychiatry, University of Arizona, Tucson, USA
| | - Karla Granados
- Department of Psychiatry, University of Arizona, Tucson, USA
| | - Chloe C A Wills
- Department of Psychiatry, University of Arizona, Tucson, USA
| | | | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - John M Ruiz
- Department of Psychology, University of Arizona, Tucson, USA
| | - Sairam Parthasarathy
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, USA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | | | - Azizi Seixas
- Department of Population Health, and Department of Psychiatry, NYU Langone Health, New York
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences and Department of Neurology, The University of Miami Miller School of Medicine Miami, USA
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3
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Saelee R, April-Sanders AK, Bird HR, Canino GJ, Duarte CS, Lugo-Candelas C, Suglia SF. Self-reported neighborhood stressors and sleep quality among Puerto Rican young adults. Sleep Health 2024; 10:295-301. [PMID: 38570224 PMCID: PMC11162948 DOI: 10.1016/j.sleh.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To examine the association between changes in self-reported neighborhood stressors and sleep quality and determine whether this varied by sociocultural context among Puerto Rican young adults. METHODS Data come from the Boricua Youth Study Health Assessment, a sample of Puerto Rican young adults from San Juan, Puerto Rico, and South Bronx, New York (n = 818; mean age=22.9years). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Neighborhood social stressors (disorder, social cohesion, and safety) were parent-reported in childhood and self-reported in young adulthood and categorized into: low in childhood/young adulthood (reference group), high in childhood/low in young adulthood, low in childhood/high in young adulthood, and high in childhood/young adulthood. Sociocultural context was based on participant residence during childhood (San Juan vs. South Bronx). RESULTS Adjusting for sociodemographic factors, living with high neighborhood stressors in both childhood and young adulthood (prevalence ratios=1.30, 95% CI: 1.01, 1.66) was associated with overall poor sleep (PSQI score >5). Among PSQI components, living with high neighborhood stressors in young adulthood only or in both time periods was associated with worse subjective sleep quality and daytime dysfunction. Additionally, there were various associations between the neighborhood stressor measures and PSQI components. Results did not differ by sociocultural context. CONCLUSION Findings suggest that living with high levels of neighborhood stressors during childhood and young adulthood may have a cumulative adverse impact on sleep quality in young adulthood.
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Affiliation(s)
- Ryan Saelee
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA.
| | - Ayana K April-Sanders
- Department of Statistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ
| | - Hector R Bird
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York City, New York, USA
| | - Glorisa J Canino
- Behavioral Sciences Research Institute, University of Puerto Rico Medical School, San Juan, Puerto Rico
| | - Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York City, New York, USA
| | - Claudia Lugo-Candelas
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York City, New York, USA
| | - Shakira F Suglia
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
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4
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Kusters CDJ, Klopack ET, Crimmins EM, Seeman TE, Cole S, Carroll JE. Short Sleep and Insomnia Are Associated With Accelerated Epigenetic Age. Psychosom Med 2024; 86:453-462. [PMID: 37594243 PMCID: PMC10879461 DOI: 10.1097/psy.0000000000001243] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Short sleep and insomnia are each associated with a greater risk of age-related disease, which suggests that insufficient sleep may accelerate biological aging. We examine whether short sleep and insomnia alone or together relates to epigenetic age among older adults. METHODS A total of 3795 men (46.3%) and women aged 56 to 100 years from the Health and Retirement Study were included. Insomnia was defined as reporting at least one insomnia symptom (difficulty falling asleep, waking up at night, or waking up too early in the morning) and feeling unrested when waking up most of the time. Those reporting <6 hours of bedtime were categorized as short sleepers. Three second- or third-generation epigenetic age acceleration clocks were derived from the 2016 Health and Retirement Study Venous Blood Study. The linear regression analysis was adjusted for age, sex, race/ethnicity, education, and obesity status. RESULTS Insomnia and short sleep were associated with acceleration of GrimAge of 0.49 (95% confidence interval [CI] = 0.03-0.94 years; p = .04) and 1.29 (95% CI = 0.52-2.07 years; p = .002) years, respectively, as well as a faster pace of aging (DunedinPACE; 0.018 [95% CI = 0.004-0.033; p = .02] and 0.022 [95% CI = -0.004 to 0.048; p = .11]). Compared with healthy sleepers, individuals with the combination of short sleep and insomnia had an accelerated GrimAge (0.97 years; 95% CI = 0.07-1.87 years, p = .04) and a greater DunedinPACE (0.032; 95% CI = 0.003-0.060, p = .04). CONCLUSIONS Our findings indicate that short sleep, insomnia, and the combination of the two are linked to epigenetic age acceleration, suggesting that these individuals have an older biological age that may contribute to risk of comorbidity and mortality.
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Affiliation(s)
- Cynthia D J Kusters
- From the Department of Epidemiology (Kusters, Seeman), Fielding School of Public Health, UCLA; Davis School of Gerontology (Klopack, Crimmins), and Leonard Davis School of Gerontology, USC; Department of Geriatrics (Seeman), and Cousins Center for Psychoneuroimmunology (Cole, Carroll), Jane & Terry Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
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Gaston SA, Alhasan DM, Johnson DA, Hale L, Harmon QE, Baird DD, Jackson CL. Perceived childhood neighborhood safety and sleep health during childhood and adulthood among a cohort of African American women. Sleep Med 2024; 117:115-122. [PMID: 38531166 DOI: 10.1016/j.sleep.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To investigate associations between perceived childhood neighborhood safety and sleep over the life course. METHODS Among a cohort of 1693 Black/African American women aged 23-35 years at enrollment (2010-2012), participants recalled neighborhood safety (safe vs. unsafe) when they were 5, 10, and 15 years old. Participants' mothers/caregivers and participants reported sleep-related health behaviors at age 5. We used ordinal logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep-related health behaviors (i.e., rarely/never or sometimes vs. mostly/always going to bed by 8:00 p.m., bed in a quiet room, bed in a dimly lit or unlit room), separately. Adulthood sleep duration and insomnia symptoms were reported at enrollment and over three follow-up periods. We applied generalized estimating equations to log binomial regression models to estimate relative risks (RR) for adulthood sleep characteristics. RESULTS AND CONCLUSIONS Four percent of participants reported an unsafe neighborhood at age 5 years, only, and 12% reported an unsafe neighborhood at all ages. Participants in perceived unsafe vs. safe neighborhoods at age 5 had higher odds of poor sleep-related health behaviors (e.g., rarely/never or sometimes going to bed in a quiet room: OR = 1.73 [1.27-2.35]). Participants in perceived unsafe vs. safe neighborhoods throughout childhood had higher risk of short sleep (RR = 1.10 [1.02-1.18]) and insomnia symptoms (RR = 1.07 [1.00-1.15]) during adulthood after adjustment for life course socioeconomic characteristics and adulthood health behaviors and characteristics. Perceived unsafe childhood neighborhood was associated with poorer sleep over the life course and may serve as an early intervention target.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY, USA
| | - Quaker E Harmon
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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6
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Benham G, Charak R, Cano-Gonzalez I, Mena Teran J, Kenemore J. Recent Stressful Life Events and Perceived Stress as Serial Mediators of the Association between Adverse Childhood Events and Insomnia. Behav Med 2024:1-12. [PMID: 38634227 DOI: 10.1080/08964289.2024.2335175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
Insomnia is common in college students and linked to poorer mental and physical health. There is growing evidence that adverse childhood experiences (ACEs) may contribute to insomnia in adulthood. However, beyond the need for additional replication of these findings, there is a need to identify underlying mechanisms that plausibly connect the two experiences. Based on a serial mediation model, the current study examined the role of two theoretically informed mediators: recent stressful life events and perceived stress. A cross-sectional survey of 2,218 college students at a large university in the southwestern United States was conducted between August 2020 and December 2021. The sample was predominantly Hispanic (96%) and female (73%), with a mean age of 20.7 years. Standardized measures of adverse childhood experiences, recent stressful life events, perceived stress, and insomnia were administered to participants online. Almost 20% of participants reported having experienced four or more adverse childhood experiences and 63% met the threshold for insomnia. Reporting four or more ACEs was associated with significantly greater insomnia severity, and this relationship was serially mediated by both recent stressful life events and perceived stress. However, recent stressful life events appeared to be the most powerful mediator. The results of the current study indicate that recent exposure to stressful life events serves as a plausible mechanism linking early adversity during childhood to adult insomnia and could therefore serve as a potential target for intervention. The findings suggest that students would benefit from university-wide efforts to reduce the number and/or intensity of common stressors.
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Affiliation(s)
- Grant Benham
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Joceline Mena Teran
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Jordan Kenemore
- Department of Psychological Science, The University of Texas Rio Grande Valley
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Savin KL, Carlson JA, Patel SR, Jankowska MM, Allison MA, Sotres-Alvarez D, Sallis JF, Talavera GA, Roesch SC, Malcarne VL, Larsen B, Rutledge T, Gallo LC. Social and built neighborhood environments and sleep health: The Hispanic Community Health Study/Study of Latinos Community and Surrounding Areas and Sueño Ancillary Studies. Sleep 2024; 47:zsad260. [PMID: 37788570 PMCID: PMC10851842 DOI: 10.1093/sleep/zsad260] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/15/2023] [Indexed: 10/05/2023] Open
Abstract
STUDY OBJECTIVES To test associations between neighborhood social, built, and ambient environment characteristics and multidimensional sleep health in Hispanic/Latino adults. METHODS Data were from San Diego-based Hispanic/Latino adults mostly of Mexican heritage enrolled in the Hispanic Community Health Study/Study of Latinos (N = 342). Home addresses were geocoded to ascertain neighborhood characteristics of greenness, walkability (density of intersections, retail spaces, and residences), socioeconomic deprivation (e.g. lower income, lower education), social disorder (e.g. vacant buildings, crime), traffic density, and air pollution (PM 2.5) in the Study of Latinos Communities and Surrounding Areas Study. Sleep dimensions of regularity, satisfaction, alertness, timing, efficiency, and duration were measured by self-report or actigraphy approximately 2 years later. Multivariable regression models accounting for study design (stratification and clustering) were used to examine associations of neighborhood variables with individual sleep dimensions and a multidimensional sleep health composite score. RESULTS Neighborhood characteristics were not significantly associated with the multidimensional sleep health composite, and there were few significant associations with individual sleep dimensions. Greater levels of air pollution (B = 9.03, 95% CI: 1.16, 16.91) were associated with later sleep midpoint, while greater social disorder (B = -6.90, 95% CI: -13.12, -0.67) was associated with earlier sleep midpoint. Lower walkability was associated with more wake after sleep onset (B = -3.58, 95% CI: -7.07, -0.09). CONCLUSIONS Living in neighborhoods with lower walkability and greater air pollution was associated with worse sleep health, but otherwise findings were largely null. Future research should test these hypotheses in settings with greater variability and investigate mechanisms of these associations.
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Affiliation(s)
- Kimberly L Savin
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Jordan A Carlson
- Center for Children’s Health Lifestyles and Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, Children’s Mercy Kansas City and University of Missouri Kansas City, Kansas City, MO, USA
| | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Matthew A Allison
- Department of Family Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Britta Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Thomas Rutledge
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Attarian H, Dunietz GL, Gavidia-Romero R, Jansen E, Johnson DA, Kelman A, Knutson K. Addressing sleep deserts: A proposed call for action. Sleep Health 2024; 10:S15-S18. [PMID: 37926658 PMCID: PMC11181961 DOI: 10.1016/j.sleh.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023]
Abstract
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.
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Affiliation(s)
- Hrayr Attarian
- Northwestern University, Feinberg School of Medicine, Department of Neurology, Chicago, Illinois, USA.
| | - Galit Levi Dunietz
- University of Michigan Medical School, Department of Neurology, Ann Arbor, Michigan, USA
| | - Ronald Gavidia-Romero
- University of Michigan Medical School, Department of Neurology, Ann Arbor, Michigan, USA
| | - Erica Jansen
- University of Michigan Medical School, Department of Neurology, Ann Arbor, Michigan, USA
| | - Dayna A Johnson
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, Georgia, USA
| | - Alexa Kelman
- University of Michigan Medical School, Department of Neurology, Ann Arbor, Michigan, USA
| | - Kristen Knutson
- Northwestern University, Feinberg School of Medicine, Department of Neurology, Chicago, Illinois, USA
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9
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Edmed SL, Huda MM, Pattinson CL, Rossa KR, Smith SS. Perceived Neighborhood Characteristics and Sleep in Australian Adults. HEALTH EDUCATION & BEHAVIOR 2024; 51:155-166. [PMID: 37306016 PMCID: PMC10785564 DOI: 10.1177/10901981231177687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Poor sleep can contribute to poorer health and socioemotional outcomes. Sleep health can be influenced by a range of individual and other socioecological factors. Perceptions of neighborhood physical and social characteristics reflect broader social-level factors that may influence sleep, which have not been well studied in the Australian context. This study examined the association between perceived neighborhood characteristics and sleep in a large sample of Australians. METHODS Data were from 9,792 people aged 16 years or older, from Waves 16 and 17 of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Associations between perceived neighborhood characteristics (neighborly interaction and support, environmental noise, physical condition, and insecurity) and self-reported sleep duration, sleep disturbance, and napping were examined using multiple logistic regression models. RESULTS "Neighborhood interaction and support" and "neighborhood physical condition" were not significantly associated with any sleep outcomes after adjusting for relevant covariates. However, "environmental noise" and "neighborhood insecurity" remained significantly associated with sleep duration and sleep disturbance. None of the neighborhood characteristics were associated with napping. Furthermore, associations did not significantly vary by gender. CONCLUSIONS This study highlights the potential benefit of public health policies to address noise and safety in neighborhoods to improve sleep.
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Affiliation(s)
- Shannon L Edmed
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - M Mamun Huda
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Cassandra L Pattinson
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for the Digital Child, The University of Queensland, Brisbane, Queensland, Australia
| | - Kalina R Rossa
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Simon S Smith
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for the Digital Child, The University of Queensland, Brisbane, Queensland, Australia
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10
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Mousavi Z, Troxel WM, Dickerson DL, Dong L, Brown RA, Palimaru AI, Klein DJ, Johnson CL, D’Amico EJ. Neighborhood determinants of sleep and the moderating role of cultural factors among native adolescents. Health Psychol 2024; 43:101-113. [PMID: 38127509 PMCID: PMC10842707 DOI: 10.1037/hea0001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study examined the association between neighborhood social environment and sleep among urban American Indian and Alaska Native (AI/AN) adolescents as well as the moderating role of cultural factors in this association. METHOD The analytic sample included 133 urban AI/AN adolescents (age 12-16, 57.1% female, Mage = 14.03, SDage = 1.35). Perceived neighborhood social environment included safety and cohesion. Cultural factors included AI/AN cultural identification and historical loss. Sleep duration, efficiency, and wake after sleep onset (WASO) were measured via actigraphy. Sleep disturbance was measured via a questionnaire. RESULTS Greater neighborhood safety was significantly associated with lower sleep disturbance (b = -2.17, SE = 0.8, p = .008), higher sleep efficiency (b = 1.75, SE = 0.64, p = .006), and lower WASO (b = -8.60, SE = 3.34, p = .01). Neighborhood cohesion was not associated with any sleep outcomes. Cultural factors moderated the association between neighborhood social environment and sleep outcomes (p < .05). Specifically, both neighborhood safety and cohesion were associated with lower sleep disturbance, only among individuals reporting higher levels of AI/AN cultural identification. Further, neighborhood safety was associated with greater sleep efficiency and lower WASO (i.e., better sleep) only among adolescents with higher contemplation of historical loss. CONCLUSIONS Findings highlight the importance of considering cultural factors in addressing sleep and health disparities. AI/AN cultural identification and a sense of historical loss may be important targets for identifying adolescents who might benefit the most from policies and interventions focused on improving the social environment in order to improve sleep and other health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Zahra Mousavi
- Department of Psychological Science, University of California, Irvine, California, USA
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Wendy M. Troxel
- Division of Behavior and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Daniel L. Dickerson
- UCLA Integrated Substance Abuse Program, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Lu Dong
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Ryan A. Brown
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Alina I. Palimaru
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - David J. Klein
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Carrie L. Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, California, USA
| | - Elizabeth J. D’Amico
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
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Kose S, Mohamed NA. The Interplay of Anxiety, Depression, Sleep Quality, and Socioeconomic Factors in Somali Hemodialysis Patients. Brain Sci 2024; 14:144. [PMID: 38391719 PMCID: PMC10887329 DOI: 10.3390/brainsci14020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE This study aimed to assess anxiety, depression, and sleep quality in kidney failure patients receiving hemodialysis (HD) in Somalia and examine the relationship between anxiety, depression, and sleep quality. METHODS We conducted a study with 200 kidney failure patients on HD treatment for over 3 months. Participants completed sociodemographic questionnaires, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS Among the 200 participants (mean age = 52.3; SD = 14.13), 58.5% were men, 64% had CKD for 1-5 years, and 52.6% received HD for 1-5 years. Depressive symptoms were found in 61.5% (PHQ-9) and 37.5% (HADS depression subscale) of HD patients. Poor sleep quality (PSQI) was observed in 31.5% and significantly correlated with PHQ-9 (rs = 0.633), HADS anxiety (rs = 0.491), and HADS depression (rs = 0.529). The ISI score correlated significantly with PHQ-9 (rs = 0.611), HADS anxiety (rs = 0.494), and HADS depression (rs = 0.586). All PSQI components correlated with depression and anxiety, except sleep medication use. Hierarchical regression analysis revealed that HADS anxiety (β = 0.342) and HADS depression (β = 0.372) predicted ISI scores. HADS anxiety (β = 0.307) and HADS depression (β = 0.419) predicted PSQI scores. CONCLUSIONS Higher anxiety and depression levels negatively correlated with various dimensions of sleep quality in kidney failure patients. Early identification and appropriate management of these psychological disturbances are crucial for enhancing patients' overall quality of life.
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Affiliation(s)
- Samet Kose
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Turkey Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
- Department of Psychiatry, Basaksehir Cam Sakura City Hospital, Health Sciences University, Istanbul 34480, Türkiye
| | - Nur Adam Mohamed
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Turkey Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
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12
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Elumn JE, Li P, Lytell MS, Garcia M, Wang EA, Klar Yaggi H. "What if that's your last sleep?" A qualitative exploration of the trauma of incarceration and sleep. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 5:zpad055. [PMID: 38314119 PMCID: PMC10838125 DOI: 10.1093/sleepadvances/zpad055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/06/2023] [Indexed: 02/06/2024]
Abstract
Study Background/Objectives Sleep is an underexplored factor in the health of people involved in the criminal legal system. This study addresses the paucity of research on how individual, social, and physical environmental factors impact sleep health during and after incarceration by highlighting the voices of people involved in the criminal legal system through a community-engaged qualitative research approach. Methods We conducted 20 semi-structured interviews with men recently released from prison for a study on trauma and healthcare during incarceration and after release. Interviews were coded and analyzed using reflexive thematic analysis and a critical realist framework. Our research team included people with a history of incarceration who performed central roles in the research process. Results Three themes emerged from participants' descriptions of sleep during and after incarceration: (1) concerns about health contributing to sleep problems, (2) lack of access to treatment for sleep disorders leading to ongoing sleep problems, and (3) issues of safety contributing to sleep problems during incarceration and after release. Conclusions This study identifies factors and domains influencing sleep during and after incarceration. By identifying which interpersonal, environmental, and structural factors impact sleep quality, medical and carceral staff are better equipped to ameliorate sleep health disparities within populations with a history of incarceration and those actively bound by the criminal legal system. Future research should examine other factors impacting sleep in incarcerated and recently released populations and develop multi-level interventions to improve sleep health. This paper is part of the Sleep and Circadian Health in the Justice System Collection.
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Affiliation(s)
- Johanna E Elumn
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Patrick Li
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Malcolm S Lytell
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Emily A Wang
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Henry Klar Yaggi
- Clinical Epidemiology Research Center, VA CT HCS, West Haven CT, USA
- Section Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
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13
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Kim HS, Lee H, Provido SMP, Chung GH, Hong S, Yu SH, Lee JE, Lee CB. Association between Sleep Duration and Metabolic Disorders among Filipino Immigrant Women: The Filipino Women's Diet and Health Study (FiLWHEL). J Obes Metab Syndr 2023; 32:224-235. [PMID: 37718118 PMCID: PMC10583772 DOI: 10.7570/jomes22032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/06/2022] [Accepted: 07/09/2023] [Indexed: 09/19/2023] Open
Abstract
Background Sleep plays a complex role in metabolic regulation, and the underlying linkage has not been clearly defined. We investigated the association between sleep duration and metabolic disorders in Filipino immigrants in Korea. Methods We analyzed 410 participants from the 2014 to 2016 baseline population of the Filipino Women's Diet and Health Study. Usual sleep duration was self-reported, and anthropometric parameters were measured directly. Blood glucose, lipid, and insulin levels were examined from fasting serum samples. We used general linear models to acquire least squares (LS) means and logistic regression models to calculate odds ratios to test the cross-sectional association between sleep duration and metabolic markers with 95% confidence intervals (CIs). Results We found a statistically significant linear association between increased sleep duration and elevated triglycerides, total cholesterol, and low-density lipoprotein cholesterol (LDL-C). LS means (95% CI) of <5, 5-6, 7-8, and >8 hours of sleep were 81.74 (71.43 to 93.54), 85.15 (76.65 to 94.59), 86.33 (77.84 to 95.75), and 105.22 (88.07 to 125.71), respectively, for triglycerides (P trend=0.049) and 174.52 (165.02 to 184.57), 180.50 (172.79 to 188.55), 182.51 (174.83 to 190.53), and 190.16 (176.61 to 204.74), respectively, for total cholesterol (P trend= 0.042). For LDL-C, the LS means (95% CI) were 97.34 (88.80 to 106.71), 100.69 (93.73 to 108.18), 104.47 (97.35 to 112.10), and 109.43 (96.94 to 123.54), respectively (P trend=0.047). Statistical significance persisted after additional adjustment for body mass index. The association with triglycerides was limited to current alcohol drinkers (P interaction=0.048). Conclusion Longer sleep duration was associated with increased triglyceride, total cholesterol, and LDL-C levels. The association with triglycerides was more pronounced among moderate alcohol drinkers.
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Affiliation(s)
- Hee Sun Kim
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Heejin Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | | | - Grace H. Chung
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
- Department of Child Development and Family Studies, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Sangmo Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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14
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Zhu X, Gao M, Cheng X, Zhao W. Sleep - the guarantee of health! Does the environmental perception characteristics of urban residential areas affect residents' sleep quality? Front Public Health 2023; 10:1017790. [PMID: 36743169 PMCID: PMC9889991 DOI: 10.3389/fpubh.2022.1017790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
A complex urban living environment and residents' sleep quality are intrinsically linked. Nonetheless, there is little evidence that the residential environment affects sleep quality. Based on the results of subjective questionnaires, this study uses the multiple regression combined with mediation analysis to construct a mechanical model of the impact of urban residential environmental perception characteristics on residents' sleep quality. Moreover, the differences among the influence intensities of the significant factors are compared and the results show that (1) in low-density environments (FAR < 2) and lower floors (4-6), residents sleep longer and have better sleep quality; (2) the environmental quality and service facilities of the physical environment and the sense of safety in the social environment have a significant impact on residents' sleep quality; and (3) the mental health of residents play a significant intermediary role in the relationship between social environment and sleep quality, with the highest effect accounting for 33.88%. The influence mechanisms of various environmental factors in a residential area on sleep quality were revealed and a more refined design basis for a healthy urban living environment, community renewal, and renovation was provided.
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Affiliation(s)
- Xun Zhu
- School of Architecture, Harbin Institute of Technology, Harbin, China,Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China
| | - Ming Gao
- School of Architecture, Harbin Institute of Technology, Harbin, China,Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China,*Correspondence: Ming Gao ✉
| | - Xinting Cheng
- School of Architecture, Harbin Institute of Technology, Harbin, China,Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China
| | - Wei Zhao
- School of Architecture, Harbin Institute of Technology, Harbin, China,Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China,Wei Zhao ✉
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15
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Gallagher VT, Reilly SE, Williams IC, Mattos M, Manning C. Patterns of sleep disturbances across stages of cognitive decline. Int J Geriatr Psychiatry 2023; 38:e5865. [PMID: 36578203 PMCID: PMC10107468 DOI: 10.1002/gps.5865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate insomnia symptoms and excessive sleep/sluggishness across stages of cognitive decline (cognitively normal [CN], Cognitively Impairment, Not Demented [CIND], dementia) in a large, racially/ethnically diverse sample of older adults (70+) in the US. We also examined whether sleep disturbances at baseline predicted conversion to CIND or dementia at follow-up. METHODS In this secondary analysis of the Aging, Demographics, and Memory Study (ADAMS) supplement of the Health Retirement Study, we analyzed patterns of informant-reported insomnia and excessive sleep symptoms among three groups of older adults (n = 846): CN, CIND, and dementia. RESULTS CIND adults were significantly more likely to have informant-reported insomnia symptoms than those in the CN group (p = 0.013). This was driven by a significant race/ethnicity-by-insomnia interaction with diagnostic status (p = 0.029), such that CIND Black and Hispanic older adults had increased insomnia symptom rates compared to CN, whereas White adults had similar insomnia symptoms across diagnostic status. Across all racial/ethnic groups, the prevalence of excessive sleep symptoms increased stepwise from CN to CIND to dementia (p < 0.001). Overall, insomnia symptoms at baseline predicted conversion from CN to CIND (p < 0.001, OR = 0.288; 95% CI: 0.143-0.580) at 4-year (approximate) follow-up; there was no relationship between baseline insomnia or excessive sleep/sluggishness symptoms and conversion from CIND to dementia. DISCUSSION/CONCLUSION This study provides evidence for the increased risk of insomnia symptoms among Hispanic and Black older adults with CIND, and indicates that insomnia symptoms may be associated with increased risk for development of cognitive impairment.
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Affiliation(s)
| | - Shannon E. Reilly
- Department of NeurologyUniversity of Virginia HealthCharlottesvilleVirginiaUSA
| | | | - Meghan Mattos
- School of NursingUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Carol Manning
- Department of NeurologyUniversity of Virginia HealthCharlottesvilleVirginiaUSA
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16
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Heinsberg LW, Carlson JC, Pomer A, Cade BE, Naseri T, Reupena MS, Weeks DE, McGarvey ST, Redline S, Hawley NL. Correlates of daytime sleepiness and insomnia among adults in Samoa. SLEEP EPIDEMIOLOGY 2022; 2:100042. [PMID: 36338277 PMCID: PMC9635619 DOI: 10.1016/j.sleepe.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective To describe daytime sleepiness and insomnia among adults in Samoa and identify modifiable factors associated with these measures. Design/setting Cross-sectional analysis of data from the Soifua Manuia ("Good Health") study (n = 519, 55.1% female); Upolu island, Samoa. Methods Daytime sleepiness and insomnia were assessed with the Epworth Sleepiness Scale (ESS) and the Women's Health Initiative Insomnia Rating Scale (WHIIRS), respectively. Detailed physical, sociodemographic, and behavioral factors were collected. Sleep measures were characterized using multiple linear regression with backwards elimination and a bootstrap stability investigation. Results Excessive daytime sleepiness (ESS>10) and insomnia (WHIIRS>10) were reported by 20% and 6.3% of the sample, respectively. ESS scores were higher in individuals reporting more physical activity (Estimate=1.88; 95% CI=1.12 to 2.75), higher material wealth (0.18; 0.09 to 0.28), and asthma (2.85; 1.25 to 4.51). ESS scores were lower in individuals residing in periurban versus urban regions (-1.43; -2.39 to -0.41), reporting no work versus day shift work (-2.26; -3.07 to -1.41), and reporting greater perceived stress (-0.14; -0.23 to -0.06). WHIIRS scores were lower in individuals reporting "other" shift work (split/irregular/on-call/rotating) versus day shift work (-1.96; -2.89 to -1.14) and those who perceived their village's wealth to be poor/average versus wealthy (-0.94; -1.50 to -0.34). Conclusions Participants had a generally higher prevalence of excessive daytime sleepiness, but lower prevalence of insomnia, compared with individuals from high-income countries. Factors associated with sleep health differed compared with prior studies, emphasizing potential cultural/environmental differences and the need for targeted interventions to improve sleep health in this setting.
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Affiliation(s)
- Lacey W. Heinsberg
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Corresponding author at: Department of Human Genetics, School of Public Health, University of Pittsburgh, Public Health 3102A, 130 De Soto Street, Pittsburgh, PA 15261. (L.W. Heinsberg)
| | - Jenna C. Carlson
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alysa Pomer
- Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Brian E. Cade
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | | | - Daniel E. Weeks
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen T. McGarvey
- International Health Institute and Department of Epidemiology, School of Public Health, and Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
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17
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May AM, Billings ME. Racial Differences in Positive Airway Pressure Adherence in the Treatment of Sleep Apnea. Sleep Med Clin 2022; 17:543-550. [PMID: 36333073 PMCID: PMC10260288 DOI: 10.1016/j.jsmc.2022.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although data are limited, studies suggest on average lower positive airway pressure use in Black, indigenous, and people of color (BIPOC) compared with Whites in most but not all studies. Most of these observational studies are certainly limited by confounding by socioeconomic status and other unmeasured factors that likely contribute to differences. The etiology of these observed disparities is likely multifactorial, due in part to financial limitations, differences in sleep opportunity, poor sleep quality due to environmental disruptions, and so forth. These disparities in sleep health are likely related to chronic inequities, including experiences of racism, neighborhood features, structural, and contextual factors. Dedicated studies focusing on understanding adherence in BIPOC are lacking. Further research is needed to understand determinants of PAP use in BIPOC subjects and identify feasible interventions to improve sleep health and reduce sleep apnea treatment disparities.
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Affiliation(s)
- Anna M May
- Research Section and Sleep Section, VA Northeast Ohio Healthcare System, Cleveland, OH, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Martha E Billings
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Washington School of Medicine, UW Medicine Sleep Center, Harborview Medical Center, Box 359803, 325 Ninth Avenue, Seattle, WA 98104, USA
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18
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Schmied EA, Full KM, Lin SF, Gregorio-Pascual P, Ayala GX. Sleep health among U.S. Hispanic/Latinx children: An examination of correlates of meeting sleep duration recommendations. Sleep Health 2022; 8:615-619. [PMID: 36055935 DOI: 10.1016/j.sleh.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The objective of this study was to examine the association between sociodemographic, behavioral, and environmental factors and adherence to sleep duration recommendations among 1165 U.S. Hispanic/Latinx children. METHODS In this cross-sectional study, the following parent-reported variables were examined as correlates of whether children met age-appropriate nightly sleep duration recommendations: caretaker and child demographics (eg, gender, age, poverty level), presence of TV in child's bedroom, child's daily screen time and bedtime. RESULTS Most (61.4%) children (mean age: 6.39 years, SD = 2.66) met sleep duration guidelines. Multivariable regression results revealed the odds of meeting recommendations were significantly higher among children 6-12 years old living above the poverty threshold (odds ratio [OR] = 1.57; 95% confidence interval [95%CI]: 1.08, 2.31) and those with a regular bedtime ("Some of the time:" OR = 2.05; 95%CI: 1.07, 3.92; "Most of the time:" OR = 3.19; 95%CI: 1.77, 5.74; "Always:" OR = 4.46; 95%CI: 2.43, 8.13). CONCLUSIONS Sleep health disparities must be addressed through culturally and contextually appropriate interventions that combine individual-level strategies with those that address social and environmental factors.
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Affiliation(s)
- Emily A Schmied
- School of Public Health, San Diego State University, and Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California, USA.
| | - Kelsie M Full
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California, USA
| | - Petrona Gregorio-Pascual
- San Diego State University & University of California, San Diego Joint Doctoral Program in Public Health, and Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California, USA
| | - Guadalupe X Ayala
- School of Public Health, San Diego State University, and Institute for Behavioral and Community Health and SDSU HealthLINK Center, San Diego State University Research Foundation, San Diego, California, USA
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McKinnon L, Shattuck EC, Samson DR. Sound reasons for unsound sleep: Comparative support for the sentinel hypothesis in industrial and nonindustrial groups. Evol Med Public Health 2022; 11:53-66. [PMID: 36945298 PMCID: PMC10024786 DOI: 10.1093/emph/eoac039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background and objectives Sleep is a vulnerable state in which individuals are more susceptible to threat, which may have led to evolved mechanisms for increasing safety. The sentinel hypothesis proposes that brief awakenings during sleep may be a strategy for detecting and responding to environmental threats. Observations of sleep segmentation and group sentinelization in hunter-gatherer and small-scale communities support this hypothesis, but to date it has not been tested in comparisons with industrial populations characterized by more secure sleep environments. Methodology Here, we compare wake after sleep onset (WASO), a quantitative measure of nighttime awakenings, between two nonindustrial and two industrial populations: Hadza hunter-gatherers (n = 33), Malagasy small-scale agriculturalists (n = 38), and Hispanic (n = 1,531) and non-Hispanic White (NHW) (n = 347) Americans. We compared nighttime awakenings between these groups using actigraphically-measured sleep data. We fit linear models to assess whether WASO varies across groups, controlling for sex and age. Results We found that WASO varies significantly by group membership and is highest in Hadza (2.44 h) and Malagasy (1.93 h) and lowest in non-Hispanic Whites (0.69 h). Hispanics demonstrate intermediate WASO (0.86 h), which is significantly more than NHW participants. After performing supplementary analysis within the Hispanic sample, we found that WASO is significantly and positively associated with increased perception of neighborhood violence. Conclusions and implications Consistent with principles central to evolutionary medicine, we propose that evolved mechanisms to increase vigilance during sleep may now be mismatched with relatively safer environments, and in part responsible for driving poor sleep health.
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Affiliation(s)
- Leela McKinnon
- Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, CanadaL5L 1C6
| | - Eric C Shattuck
- Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, CanadaL5L 1C6
- Institute for Health Disparities Research, University of Texas at San Antonio, San Antonio, TX 78249, USA
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - David R Samson
- Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, CanadaL5L 1C6
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Bayly JE, Panigrahi A, Rodriquez EJ, Gallo LC, Perreira KM, Talavera GA, Estrella ML, Daviglus ML, Castaneda SF, Bainter SA, Chambers EC, Savin KL, Loop M, Pérez-Stable EJ. Perceived neighborhood factors, health behaviors, and related outcomes in the Hispanic Community Health Study/Study of Latinos. Prev Med 2022; 164:107267. [PMID: 36150447 PMCID: PMC9691577 DOI: 10.1016/j.ypmed.2022.107267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/31/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022]
Abstract
Hispanic/Latino populations may experience significant neighborhood disadvantage, but limited research has explored whether these factors affect their health behaviors. Associations between perceived neighborhood factors at Visit 1 and health behaviors and related outcomes at Visit 2 in the Hispanic Community Health Study/Study of Latinos were evaluated. Multivariable logistic regression assessed cross-sectional and longitudinal relationships between perceived neighborhood social cohesion (NSC, 5 items), and neighborhood problems (NP, 7 items), with cancer screening, current smoking, excessive/binge drinking, hypertension, obesity, physical activity, and poor diet by gender and birthplace. NSC and NP scores were converted into quartiles. Mean age of participants was 42.5 years and 62.1% were women. Perceived NP, but not perceived NSC, differed by gender (p < 0.001). In unstratified models, no significant associations were observed between perceived NSC and any health behavior, whereas greater perceived NP was associated with less adherence to colon cancer screening (moderate level: aOR = 0.68, 95% CI = 0.51, 090) and more physical activity (very high level: aOR = 1.34, 95% CI = 1.06, 1.69) compared to low perceived NP. Women with moderate perceived NP, versus low NP, had a lower odds of colon cancer screening at Visit 1 (aOR = 0.62, 95% CI = 0.43, 0.91) and higher odds of mammogram adherence at Visit 2 (aOR = 2.86, 95% CI = 1.44, 5.68). Men with high perceived NP had a higher odds of excessive or binge drinking at Visit 2 (aOR = 1.99, 95% CI = 1.19, 3.31). We conclude that perceived NP were significantly related to health behaviors among HCHS/SOL individuals. Perceptions of neighborhood environment may be considered modifiable factors of structural neighborhood environment interventions.
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Affiliation(s)
- Jennifer E Bayly
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States of America.
| | - Asmi Panigrahi
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America.
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America.
| | - Linda C Gallo
- Department of Psychology, San Diego State University, CA, United States of America.
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America.
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, CA, United States of America.
| | - Mayra L Estrella
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, TX, United States of America.
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, IL, United States of America.
| | - Sheila F Castaneda
- Department of Psychology, San Diego State University, CA, United States of America.
| | - Sierra A Bainter
- Department of Psychology, University of Miami, FL, United States of America.
| | - Earle C Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, NY, United States of America.
| | - Kimberly L Savin
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America.
| | - Matthew Loop
- Department of Biostatistics, University of North Carolina School of Public Health, Chapel Hill, NC, United States of America.
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America; Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States of America.
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21
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Valladares-Garrido MJ, Zapata-Castro LE, Peralta CI, García-Vicente A, Astudillo-Rueda D, León-Figueroa DA, Díaz-Vélez C. Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11035. [PMID: 36078753 PMCID: PMC9518033 DOI: 10.3390/ijerph191711035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.
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Affiliation(s)
- Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima 15046, Peru
- Hospital Regional Lambayeque, Chiclayo 14012, Peru
| | - Luis E. Zapata-Castro
- Faculty of Medicine, Universidad Nacional de Piura, Piura 20002, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura 20002, Peru
| | - C. Ichiro Peralta
- Faculty of Medicine, Universidad Nacional Federico Villarreal, Lima 15088, Peru
| | - Abigaíl García-Vicente
- Faculty of Medicine, Universidad Nacional de Piura, Piura 20002, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura 20002, Peru
| | | | - Darwin A. León-Figueroa
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima 15013, Peru
- Faculty of Medicine, Universidad de San Martín de Porres, Chiclayo 14012, Peru
| | - Cristian Díaz-Vélez
- School of Medicine, Universidad Privada Antenor Orrego, Trujillo 13008, Peru
- Instituto de Evaluación de Tecnologías en Salud e Investigación-IETSI, EsSalud, Lima 15072, Peru
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22
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Fong KC, Heo S, Lim CC, Kim H, Chan A, Lee W, Stewart R, Choi HM, Son JY, Bell ML. The Intersection of Immigrant and Environmental Health: A Scoping Review of Observational Population Exposure and Epidemiologic Studies. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:96001. [PMID: 36053724 PMCID: PMC9438924 DOI: 10.1289/ehp9855] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/05/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Transnational immigration has increased since the 1950s. In countries such as the United States, immigrants now account for > 15 % of the population. Although differences in health between immigrants and nonimmigrants are well documented, it is unclear how environmental exposures contribute to these disparities. OBJECTIVES We summarized current knowledge comparing immigrants' and nonimmigrants' exposure to and health effects of environmental exposures. METHODS We conducted a title and abstract review on articles identified through PubMed and selected those that assessed environmental exposures or health effects separately for immigrants and nonimmigrants. After a full text review, we extracted the main findings from eligible studies and categorized each article as exposure-focused, health-focused, or both. We also noted each study's exposure of interest, study location, exposure and statistical methods, immigrant and comparison groups, and the intersecting socioeconomic characteristics controlled for. RESULTS We conducted a title and abstract review on 3,705 articles, a full text review on 84, and extracted findings from 50 studies. There were 43 studies that investigated exposure (e.g., metals, organic compounds, fine particulate matter, hazardous air pollutants) disparities, but only 12 studies that assessed health disparities (e.g., mortality, select morbidities). Multiple studies reported higher exposures in immigrants compared with nonimmigrants. Among immigrants, studies sometimes observed exposure disparities by country of origin and time since immigration. Of the 50 studies, 43 were conducted in North America. DISCUSSION The environmental health of immigrants remains an understudied area, especially outside of North America. Although most identified studies explored potential exposure disparities, few investigated subsequent differences in health effects. Future research should investigate environmental health disparities of immigrants, especially outside North America. Additional research gaps include the role of immigrants' country of origin and time since immigration, as well as the combined effects of immigrant status with intersecting socioeconomic characteristics, such as race/ethnicity, income, and education attainment. https://doi.org/10.1289/EHP9855.
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Affiliation(s)
- Kelvin C. Fong
- School of the Environment, Yale University, New Haven, Connecticut, USA
- Department of Earth and Environmental Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Seulkee Heo
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Chris C. Lim
- Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Honghyok Kim
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Alisha Chan
- School of the Environment, Yale University, New Haven, Connecticut, USA
- School of Engineering & Applied Science, Yale University, New Haven, Connecticut, USA
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, Connecticut, USA
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Rory Stewart
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | | | - Ji-Young Son
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut, USA
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23
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Roncoroni J, Okun M, Hudson A. Systematic review: sleep health in the US Latinx population. Sleep 2022; 45:zsac092. [PMID: 35460556 DOI: 10.1093/sleep/zsac092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/10/2022] [Indexed: 09/19/2023] Open
Abstract
Sleep disturbances are a common and unmet health problem in Latinx. While Latinx report similar sleep disturbances as non-Hispanic Whites [NHW], Latinx suffer from these disturbances to a greater degree than their NHW counterparts. Sleep disturbances are associated with increased risk of chronic health conditions, which Latinx experience at high rates. Research also points to significant sleep differences within Latinx. Given that Latinx are a rapidly growing population in the United States, sleep disparities between Latinx and NHWs and sleep differences within Latinx warrant further investigation. While research on Latinx sleep is growing, the last narrative review on US Latinx sleep health was published by Loredo and colleagues in 2010. Our narrative review expands on Loredo et al.'s work, adding the literature on Latinx sleep published since 2010 (N = 70). A total of 78 peer-reviewed articles related to young to middle-aged (i.e., 18-65 years) healthy Latinx adult sleep were identified in three databases-PsycInfo, PubMed/Medline, and Web of Science. With the socioecological model as framework, this review (1) summarizes current evidence pertaining to sleep health in healthy, community dwelling, urban Latinx adults; (2) discusses measurement challenges related to investigating Latinx sleep disparities and differences; and (3) discusses potential contributors to Latinx sleep. The prevalence of short sleep duration, long sleep duration, and poor sleep quality is high among Latinx; there are differences by Latinx subgroup. Our review identifies several multi-level influences associated with poor sleep: SES, sexual minority status, racial discrimination, access to care, neighborhood environment, and shift work. N = 250/250.
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Affiliation(s)
- Julia Roncoroni
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Michele Okun
- Psychology Department University of Colorado, Colorado Springs, CO, USA
| | - Amy Hudson
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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24
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Mental Health Disturbance after a Major Earthquake in Northern Peru: A Preliminary, Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148357. [PMID: 35886205 PMCID: PMC9319911 DOI: 10.3390/ijerph19148357] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
Abstract
Little has been studied in Peru on the mental health repercussions after a major earthquake. We aimed to explore the factors associated with depressive and anxiety symptoms in people who experienced a 6.1 magnitude earthquake in Piura, Peru, on 30 July 2021. A preliminary cross-sectional study was conducted in the general population between August–September 2021. An online questionnaire was provided using PHQ-9, GAD-7, and other relevant measures. Generalized linear models were applied. Of the 177 participants, the median age was 22 years, the majority were female (56%), and many experienced depressive (52%) or anxiety symptoms (52%). Presence of depressive symptoms was associated with a personal history of mental disorder, moderate housing damage, social/material support from politicians, moderate food insecurity, and insomnia. Presence of anxiety symptoms was associated with physical injury caused by the earthquake, mild food insecurity, and insomnia. The development of depressive and anxiety symptoms following the 2021 earthquake experienced in Piura depended on multiple individual and socioeconomic factors. Additional studies should reinforce the factors identified here given the methodological limitations, such as the study design, sampling method, and sample size. This would lead to effective intervention measures to mitigate the impact of earthquakes on mental health.
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25
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Kim B, Branas CC, Rudolph KE, Morrison CN, Chaix B, Troxel WM, Duncan DT. Neighborhoods and sleep health among adults: A systematic review. Sleep Health 2022; 8:322-333. [DOI: 10.1016/j.sleh.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
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26
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Zhan C, Nagy GA, Wu JQ, McCabe B, Stafford AM, Gonzalez-Guarda RM. Acculturation Stress, Age at Immigration, and Employment Status as Predictors of Sleep Among Latinx Immigrants. J Immigr Minor Health 2022; 24:1408-1420. [PMID: 35291029 DOI: 10.1007/s10903-022-01342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
Abstract
Sleep is important for physical and mental health. Latinx individuals are thought to experience worse sleep and associated health outcomes, resulting in health disparities. There is a dearth of research on the factors (e.g., employment status, age at immigration) that predict poor sleep among Latinx immigrants. The present study aimed to (1) examine the link between demographic factors, immigration-related factors, and acculturation stress, and sleep, and (2) identify factors that either attenuate or intensify the link between acculturation stress and sleep among Latinx immigrants in the US South, an immigrant-hostile area that is home to an increasing Latinx population that remains understudied. Hierarchical regressions were used to analyze data from 391 Latinx adult immigrants, examining the link between demographic factors, immigration-related factors, acculturation stress, and two sleep variables (sleep quality, difficulty falling asleep). Employment status and age at immigration were examined as moderators of the link between acculturation stress and sleep. Data were collected through in-person surveys. Regressions showed that acculturation stress was significantly linked to worse sleep quality (β = 0.30, p = 0.001) and more difficulty falling asleep (β = 0.41, p < 0.001), while controlling for participant characteristics. Younger age at immigration (β = - 0.14, p = 0.005) and being unemployed (β = - 0.13, p = 0.006) were associated with more difficulty falling asleep. Age at immigration intensified the relationship between acculturation stress and sleep quality (β = 0.14, p = 0.005), difficulty falling asleep (β = 0.15, p = 0.002). Reducing acculturation stress is a meaningful intervention focus, with important implications for sleep health, particularly for recent Latinx immigrants. Age at immigration and employment status are also important factors to consider when designing targeted interventions.
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Affiliation(s)
- Chanel Zhan
- Duke University School of Medicine, Durham, NC, USA.
| | - Gabriela A Nagy
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC, 27710, USA
| | - Jade Q Wu
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Brian McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Allison M Stafford
- Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC, 27710, USA
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27
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Zamora AN, Arboleda-Merino L, Tellez-Rojo MM, O'Brien LM, Torres-Olascoaga LA, Peterson KE, Banker M, Fossee E, Song PX, Taylor K, Cantoral A, Roberts EFS, Jansen EC. Sleep Difficulties among Mexican Adolescents: Subjective and Objective Assessments of Sleep. Behav Sleep Med 2022; 20:269-289. [PMID: 33983860 PMCID: PMC8589870 DOI: 10.1080/15402002.2021.1916497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE/BACKGROUND Self-reported sleep difficulties, such as insomnia symptoms, have been reported among adolescents. Yet, studies of their prevalence and correlates are scarce among Latin Americans. This study sought (1) to describe associations between sociodemographic and lifestyle factors with self-reported sleep difficulties and (2) to examine associations between self-reported sleep difficulties and actigraphy-based sleep. PARTICIPANTS Participants included 477 Mexican adolescents from the ELEMENT cohort. METHODS Over 7 days, self-reported sleep measures (hard time falling asleep, overall sleep difficulties, and specific types of sleep difficulties) were obtained from daily sleep diaries. Actigraphy-based sleep measures (duration, i.e. sleep onset to morning wake, midpoint, and fragmentation) were concurrently assessed using a wrist actigraph. RESULTS Mean (SD) age was 15.9 (2.2) years, and 53.5% were females. Mean (SD) sleep duration was 8.5 (1.2) h/night. Half reported a hard time falling asleep at least 3 days, and 25% had sleep difficulties at least 3 days over 7 days. The 3 types of sleep difficulties commonly reported among the entire cohort were insomnia/restlessness (29%), environmental (27%), and mental/emotional difficulties (19%). Female sex, smoking behavior, and socioeconomic indicators were among the most consistent factors associated with sleep difficulties. Subjective sleep difficulties were associated with shorter sleep duration (β = -20.8 [-35.3, -6.2] min), while subjective hard time falling asleep was associated with longer sleep duration (β = 11.3 [4.6, 27.2] min). CONCLUSION A high proportion of Mexican adolescents in the sample reported sleep difficulties. Findings demonstrate the importance of obtaining subjective and objective sleep measures for a more comprehensive assessment of adolescent sleep.
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Affiliation(s)
- Astrid N Zamora
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Laura Arboleda-Merino
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Martha Maria Tellez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Louise M O'Brien
- Department of Neurology, Division of Sleep Medicine, Michigan Medicine, Ann Arbor, Michigan.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Libni A Torres-Olascoaga
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Margaret Banker
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Erica Fossee
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Peter X Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Kirstyn Taylor
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | | | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.,Department of Neurology, Division of Sleep Medicine, Michigan Medicine, Ann Arbor, Michigan
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28
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Testa A, Fahmy C, Hill TD. Perceptions of neighborhood dangerousness and changes in sleep quality during the COVID-19 pandemic: Assessing the mediating role of changes in health behaviors. Prev Med 2022; 156:106991. [PMID: 35167855 PMCID: PMC8837485 DOI: 10.1016/j.ypmed.2022.106991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/02/2021] [Accepted: 02/06/2022] [Indexed: 11/25/2022]
Abstract
Numerous studies have demonstrated that neighborhood context contributes to variations in morbidity and mortality. This body of work includes a burgeoning literature that links adverse neighborhood characteristics (e.g., neighborhood poverty and perceptions of disorder and dangerousness) with poorer sleep outcomes. During the COVID-19 pandemic, many neighborhoods exhibited socioeconomic downturns and escalations in crime and violence. The question is the extent to which these changes in neighborhood conditions have impacted the sleep quality of residents. In this paper, we use original survey data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of adults living in the U.S., to formally test whether changes in perceptions of neighborhood dangerousness during the pandemic are associated with sleep quality during the same period. Regression analyses show that while reports of a neighborhood becoming safer during the pandemic are associated with better sleep quality, reports of a neighborhood becoming more dangerous are associated with worse sleep quality. Mediation analyses also indicate that the association between increased neighborhood dangerousness and poorer sleep quality is partially explained by a concurrent deterioration in diet quality, but not increases in alcohol or cigarette consumption. We conclude with a discussion of the implications of our findings for research and policy on neighborhood context and sleep.
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Affiliation(s)
- Alexander Testa
- University of Texas at San Antonio, Department of Criminology & Criminal Justice, United States of America.
| | - Chantal Fahmy
- University of Texas at San Antonio, Department of Criminology & Criminal Justice, United States of America.
| | - Terrence D Hill
- University of Texas at San Antonio, Department of Sociology, United States of America.
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29
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Cheng P, Casement MD, Cuellar R, Johnson DA, Kalmbach D, Cuamatzi Castelan A, Drake CL. Sleepless in COVID-19: racial disparities during the pandemic as a consequence of structural inequity. Sleep 2022; 45:zsab242. [PMID: 34788453 PMCID: PMC8689929 DOI: 10.1093/sleep/zsab242] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/03/2021] [Indexed: 12/23/2022] Open
Abstract
STUDY OBJECTIVES Insomnia has been on the rise during the 2019 coronavirus disease (COVID-19) pandemic, which may disproportionately affect racial minorities. This study characterized racial disparities in insomnia during the pandemic and evaluated mechanisms for such disparities. METHODS Participants included 196 adults (48 Black) from a 2016-2017 clinical trial of insomnia treatment who were reevaluated in April 2020. Race was evaluated as a predictor of change in insomnia, impact of COVID-19, and COVID-19 stress. Mediation models using the PRODCLIN method evaluated the extent to which: (1) COVID-19 impact accounted for Black-White disparities in change in insomnia, and (2) COVID-19 stress accounted for associations between discrimination and change in insomnia. RESULTS Increases in insomnia symptoms during COVID-19 were greater in Black compared to White participants, with 4.3 times the odds of severe insomnia (Insomnia Severity Index ≥ 22). Symptom severity was associated with pre-pandemic experiences of discrimination. Black participants were also disproportionately impacted by COVID-19, with twice the odds of irreparable loss of income/employment and four times the rate of COVID-19 diagnoses in their sociofamilial network compared to White participants. The disproportionate impact of COVID-19 accounted for 69.2% of the relationship between race and change in insomnia severity, and COVID-19 related stress accounted for 66.5% of the relationship between prior history of racial discrimination and change in insomnia severity. CONCLUSIONS Black-White disparities in insomnia severity during COVID-19 may be driven by structural inequities resulting in the disproportionate impact of COVID-19 on Black Americans. Results lend support for the minority stress model in the context of sleep health. CLINICAL TRIAL REGISTRATION Sleep to Prevent Evolving Affecting Disorders (SPREAD). NCT number: NCT02988375. https://clinicaltrials.gov/ct2/show/NCT02988375.
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Affiliation(s)
- Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Ruby Cuellar
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David Kalmbach
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Detroit, MI, USA
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30
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Machado-Rodrigues AM, Rodrigues D, Gama A, Nogueira H, Mascarenhas LP, Padez C. Sleep duration, risk of obesity, and parental perceptions of residential neighborhood environments in 6-9 years-old children. Am J Hum Biol 2021; 34:e23668. [PMID: 34410021 DOI: 10.1002/ajhb.23668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/22/2021] [Accepted: 08/01/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The present study aimed to analyze the association between healthy sleep duration of children and the parental perception of the social/built environment. METHODS A cross-sectional study was done and a sample of 8273 children (4183 females) aged 6-9 years was observed. Height (cm) and weight (Kg) were measured, and the body mass index (BMI) was calculated. Participants were classified as normal weight or overweight/obese. Sleep habits, sedentary behaviors (i.e., TV viewing) and environmental variables were assessed by questionnaire. Logistic regressions were used, with adjustments for age, sex, BMI, and sedentary time. RESULTS Children whose parents reported a positive perception of the built environment in the residential area were 1.21 times more likely to have regular sleep habits during weekdays. Furthermore, children whose parents reported a negative perception of the social environment and safety were 81% more likely to have irregular sleep habits during the weekdays. CONCLUSIONS The present study revealed a positive association between regular sleep during the weekdays and the parental perception of the social/built environment (land use and urban design).
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Affiliation(s)
- Aristides M Machado-Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal.,High School of Education, Ci&DEI, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Daniela Rodrigues
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Augusta Gama
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Helena Nogueira
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
| | - Luís P Mascarenhas
- UniCentro, Department of Physical Education, Midwestern Paraná State University, Curitiba, Brazil
| | - Cristina Padez
- Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal
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Dubowitz T, Haas A, Ghosh-Dastidar B, Collins RL, Beckman R, Brooks Holliday S, Richardson AS, Hale L, Buysse DJ, Buman MP, Troxel WM. Does investing in low-income urban neighborhoods improve sleep? Sleep 2021; 44:6071376. [PMID: 33417708 PMCID: PMC8193558 DOI: 10.1093/sleep/zsaa292] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/23/2020] [Indexed: 12/30/2022] Open
Abstract
STUDY OBJECTIVES Neighborhood disadvantage is associated with poor sleep, which may contribute to and exacerbate racial and socioeconomic health disparities. Most prior work has been cross-sectional and thus it has not been possible to estimate causal effects. METHODS We leveraged a natural experiment opportunity in two low-income, predominantly African American Pittsburgh, PA neighborhoods, following a randomly selected cohort of households (n = 676) between 2013 and 2016. One of the neighborhoods received substantial public and private investments (housing, commercial) over the study period, while the other socio-demographically similar neighborhood received far fewer investments. Primary analyses used a difference-in-difference analysis based on neighborhood, to examine changes in actigraphy-assessed sleep duration, efficiency, and wakefulness after sleep onset (WASO), and self-reported sleep quality. Secondary analyses examined whether residents' proximity to investments, regardless of neighborhood, was associated with changes in sleep outcomes. RESULTS Resident sleep worsened over time in both neighborhoods with no significant differences among residents between the two neighborhoods. Secondary analyses, including covariate adjustment and propensity score weighting to improve comparability, indicated that regardless of neighborhood, those who lived in closer proximity to investments (<0.1 mile) were significantly less likely to experience decreases in sleep duration, efficiency, and quality, or increases in WASO, compared to those who lived farther away. CONCLUSIONS While we did not observe sleep differences among residents between neighborhoods, living closer to a neighborhood investment was associated with better sleep outcomes. Findings have relevance for public health and policy efforts focused on investing in historically disinvested neighborhoods.
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Affiliation(s)
- Tamara Dubowitz
- RAND Corporation, Pittsburgh, PA
- Corresponding author. Tamara Dubowitz, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213.
| | - Ann Haas
- RAND Corporation, Pittsburgh, PA
| | | | | | | | | | | | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ
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O J, Pugh-Jones C, Clark B, Trott J, Chang L. The Evolutionarily Mismatched Impact of Urbanization on Insomnia Symptoms: a Short Review of the Recent Literature. Curr Psychiatry Rep 2021; 23:28. [PMID: 33797626 PMCID: PMC8018921 DOI: 10.1007/s11920-021-01239-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW For the most part of human existence, individuals have been living a rural lifestyle in a rural setting. However, such sleep-conducive conditions have largely been transformed dramatically by urbanization within a relatively short span of time in recent history, and the resulting evolved mechanisms-environment mismatch is theorized to bring about an increased risk for insomnia symptoms. This brief review of the recent literature is designed to evaluate the veracity of this proposition. RECENT FINDINGS The majority of recent findings have suggested that most proposed evolutionarily mismatched urban factors are indeed related to the presence of insomnia symptoms. However, there is a general paucity of longitudinal evidence (and for some other factors, a lack of enough evidence of any kind). Although there is a preponderance of recent findings indicating a link between evolutionarily mismatched urban phenomena and insomnia symptoms, more longitudinal data are needed before any causative conclusion can be drawn.
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Affiliation(s)
- Jiaqing O
- Department of Psychology, Aberystwyth University, Aberystwyth, UK.
| | | | | | - Jenna Trott
- Department of Psychology, Aberystwyth University, Aberystwyth, UK
| | - Lei Chang
- Department of Psychology, University of Macau, Macau, China
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Chan CMH, Siau CS, Wong JE, Wee LH, Jamil NA, Hoe VCW. Prevalence of Insufficient Sleep and Its Associated Factors Among Working Adults in Malaysia. Nat Sci Sleep 2021; 13:1109-1116. [PMID: 34285616 PMCID: PMC8286118 DOI: 10.2147/nss.s295537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/12/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Given the scarcity of data on sleep insufficiency in developing countries and its emerging importance in public health, this study aims to provide the prevalence and factors associated with insufficient sleep among working Malaysian adults. MATERIALS AND METHODS A total of 11,356 working adults (≥18 years) were recruited from a cross-sectional online health and work survey. Sleep duration was self-reported and was categorised as insufficient sleep (<7 h) and sufficient sleep (≥7 h) based on the National Sleep Guidelines' daily sleep time recommendation for adults. The 10-item Kessler scale was used to assess psychological distress levels (cutoff score ≥20). Bivariate and multivariable regression analyses were performed to examine the factors associated with insufficient sleep. RESULTS The mean age of the participants was 35.7 years (standard deviation, SD±9.2). There were more female (n=6613; 58.2%) respondents. The mean sleep duration was 6.49 h (SD±1.10). A total of 6212 individuals (54.7%) reported getting <7 h of sleep daily. After adjusting for gender, marital status and educational attainment, older age (odds ratio, OR=2.22, 95% confidence interval, 95% CI: 1.72-2.86), ever smoking (OR=1.38, 95% CI: 1.25-1.53), and high psychological distress (OR=1.33, 95% CI: 1.17-1.53) were found to be associated with insufficient sleep. Factors associated with sleep duration of <7 h per night included having children (OR=1.35, 95% CI: 1.21-1.50), lifestyle factors (OR=1.38, 95% CI: 1.25-1.53), poor sleeping conditions (OR=1.21, 95% CI: 1.07-1.36), and mental health issues (OR=1.32, 95% CI: 1.12-1.54). DISCUSSION AND CONCLUSION More than half of the participants reported sleep insufficiency. Older age, ever smoking, and high levels of psychological distress were significantly associated with insufficient sleep. Our findings recognise sleep as an emerging public health issue. Smoking cessation programmes and addressing high psychological distress may be beneficial to improve sleep.
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Affiliation(s)
- Caryn Mei Hsien Chan
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jyh Eiin Wong
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Victor Chee Wai Hoe
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Tomfohr-Madsen L, Cameron EE, Dhillon A, MacKinnon A, Hernandez L, Madigan S, Tough S. Neighborhood socioeconomic status and child sleep duration: A systematic review and meta-analysis. Sleep Health 2020; 6:550-562. [DOI: 10.1016/j.sleh.2020.02.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/23/2020] [Accepted: 02/18/2020] [Indexed: 12/20/2022]
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Billings ME, Cohen RT, Baldwin CM, Johnson DA, Palen BN, Parthasarathy S, Patel SR, Russell M, Tapia IE, Williamson AA, Sharma S. Disparities in Sleep Health and Potential Intervention Models: A Focused Review. Chest 2020; 159:1232-1240. [PMID: 33007324 PMCID: PMC7525655 DOI: 10.1016/j.chest.2020.09.249] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 08/25/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022] Open
Abstract
Disparities in sleep health are important but underrecognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socioeconomic status, racism, discrimination, neighborhood segregation, geography, social patterns, and access to health care as well as by cultural beliefs, necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities. Pediatric sleep disparities require innovative and urgent intervention to establish a foundation of lifelong healthy sleep. Tapping the vast potential of technology in improving sleep health access may be an underutilized tool to reduce sleep heath disparities. Identifying, implementing, replicating, and disseminating successful interventions to address sleep disparities have the potential to reduce overall disparities in health and quality of life.
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Affiliation(s)
- Martha E Billings
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA
| | - Robyn T Cohen
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Carol M Baldwin
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Brian N Palen
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA; Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | | | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Maureen Russell
- Northern Arizona University, Institute for Human Development, Flagstaff, AZ
| | - Ignacio E Tapia
- Sleep Center, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Ariel A Williamson
- Sleep Center, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sunil Sharma
- Division of Pulmonary, Critical Care, and Sleep Medicine, West Virginia University, WV.
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Guandalini LS, da Silva EF, Lopes JDL, Santos VB, Lopes CT, de Barros ALBL. Analysis of the evidence of related factors, associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia. Int J Nurs Sci 2020; 7:466-476. [PMID: 33195760 PMCID: PMC7644560 DOI: 10.1016/j.ijnss.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/12/2020] [Accepted: 09/10/2020] [Indexed: 02/05/2023] Open
Abstract
Objectives To summarize evidence in the literature on the predictors of insomnia in adults and to determine correspondences with diagnostic indicators of the NANDA-I diagnosis Insomnia. Methods An integrative review performed in Pubmed, Virtual Health Library and CINAHL. Forty-eight articles published in Portuguese, English or Spanish from 2011 to 2018 were included. An analysis of correspondence between the predictors and the NANDA-I related factors and associated conditions for Insomnia was performed. Results There was a correspondence of the predictors found in this review with NANDA-I related factors and associated conditions, except for grieving and frequent naps during the day. Smoking, caffeine intake, dysfunctional sleep beliefs, obesity and caregiver role strain are possible new related factors; chronic illness is a possible new associated condition and individuals going through changes in marital status, economically disadvantaged, female gender, increasing age and night shift worker are possible new at-risk populations. Conclusion The predictors of insomnia that had a correspondence with the NANDA-I elements can support the evidence base of the nursing diagnosis. The predictors found without a correspondence with the diagnosis can be considered for inclusion in the NANDA-I classification, thereby supporting the clinical reasoning of nurses and students.
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Affiliation(s)
- Lidia Santiago Guandalini
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.,São Paulo Hospital, São Paulo, Brazil
| | | | | | | | - Camila Takao Lopes
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
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37
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Yiallourou SR, Maguire GP, Carrington MJ. Sleep quantity and quality and cardiometabolic risk factors in Indigenous Australians. J Sleep Res 2020; 30:e13067. [PMID: 32526810 DOI: 10.1111/jsr.13067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 01/11/2023]
Abstract
Poor sleep is associated with increased risk of cardiovascular disease (CVD). Indigenous Australians have 1.3 times higher risk of CVD compared to non-indigenous Australians. However, there are limited data describing sleep problems and cardiometabolic risk in this population. This study aimed to investigate sleep quantity and quality in indigenous Australians and assess its association with cardiometabolic risk. Two hundred and forty-five indigenous Australians aged > 18 years were recruited via convenience sampling from communities in the Northern Territory and Queensland. Sleep quantity and quality was assessed subjectively with questionnaires including the Epworth Sleepiness Scale. In a sub-population (n = 46), objective sleep assessment was performed over three nights of actigraphy. Cardiometabolic risk measures included glycated haemoglobin, lipids, anthropometric measurements and sitting blood pressure. Sleep duration measured subjectively and objectively averaged 7.5 ± 2.0 hr/night; however, over one-third of participants (self-report 35%; actigraphy 39%) obtained < 7 hr/night. Overall, more than a third of participants experienced poor-quality sleep, with 27% reporting severe daytime sleepiness (ESS score > 10) and a high number of objectively measured awakenings/night (6 ± 4). Short sleep duration (<6 hr/night) measured both subjectively and objectively was an independent predictor of diastolic (β = 5.37, p = .038) and systolic blood pressure (β = 14.30, p = .048). More objectively measured night-time awakenings were associated with increased glycated haemoglobin levels (β = 0.07, p = .020) and greater sleep fragmentation was associated with lower high-density lipoprotein levels (β = -0.01, p = .025). A large proportion of indigenous Australians experienced short sleep durations and had significant sleep disruption. Poor sleep quantity and quality may contribute to heightened cardiometabolic risk in this population.
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Affiliation(s)
| | - Graeme P Maguire
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,General Internal Medicine, Western Health, Melbourne, Victoria, Australia
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38
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Matsui K, Komada Y, Nishimura K, Kuriyama K, Inoue Y. Prevalence and Associated Factors of Nocturnal Eating Behavior and Sleep-Related Eating Disorder-Like Behavior in Japanese Young Adults: Results of an Internet Survey Using Munich Parasomnia Screening. J Clin Med 2020; 9:jcm9041243. [PMID: 32344700 PMCID: PMC7230506 DOI: 10.3390/jcm9041243] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
Nocturnal (night) eating syndrome and sleep-related eating disorder have common characteristics, but are considered to differ in their level of consciousness during eating behavior and recallability. To date, there have been no large population-based studies determining their similarities and differences. We conducted a cross-sectional web-based survey for Japanese young adults aged 19-25 years to identify factors associated with nocturnal eating behavior and sleep-related eating disorder-like behavior using Munich Parasomnia Screening and logistic regression. Of the 3347 participants, 160 (4.8%) reported experiencing nocturnal eating behavior and 73 (2.2%) reported experiencing sleep-related eating disorder-like behavior. Smoking (p < 0.05), use of hypnotic medications (p < 0.01), and previous and/or current sleepwalking (p < 0.001) were associated with both nocturnal eating behavior and sleep-related eating disorder-like behavior. A delayed sleep-wake schedule (p < 0.05) and sleep disturbance (p < 0.01) were associated with nocturnal eating behavior but not with sleep-related eating disorder-like behavior. Both nocturnal eating behavior and sleep-related eating disorder-like behavior had features consistent with eating disorders or parasomnias. Nocturnal eating behavior but not sleep-related eating disorder-like behavior was characterized by a sleep-awake phase delay, perhaps representing an underlying pathophysiology of nocturnal eating syndrome.
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Affiliation(s)
- Kentaro Matsui
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo 1510053, Japan;
- Department of Psychiatry, Tokyo Women’s Medical University, Tokyo 1628666, Japan;
- Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 1878551, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 1878551, Japan;
| | - Yoko Komada
- Liberal Arts, Meiji Pharmaceutical University, Tokyo 2048588, Japan;
| | - Katsuji Nishimura
- Department of Psychiatry, Tokyo Women’s Medical University, Tokyo 1628666, Japan;
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 1878551, Japan;
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo 1510053, Japan;
- Department of Somnology, Tokyo Medical University, Tokyo 1608402, Japan
- Correspondence: ; Tel.: +81-3-6300-5401
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The Association of Ambient Air Pollution with Sleep Apnea: The Multi-Ethnic Study of Atherosclerosis. Ann Am Thorac Soc 2020; 16:363-370. [PMID: 30571166 DOI: 10.1513/annalsats.201804-248oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Air pollution may influence sleep through airway inflammation or autonomic nervous system pathway alterations. Epidemiological studies may provide evidence of relationships between chronic air pollution exposure and sleep apnea. OBJECTIVES To determine whether ambient-derived pollution exposure is associated with obstructive sleep apnea and objective sleep disruption. METHODS We analyzed data from a sample of participants in MESA (Multi-Ethnic Study of Atherosclerosis) who participated in both the Sleep and Air studies. Mean annual and 5-year exposure levels to nitrogen dioxide (NO2) and particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) were estimated at participants' homes using spatiotemporal models based on cohort-specific monitoring. Participants completed in-home full polysomnography and 7 days of wrist actigraphy. We used multivariate models, adjusted for demographics, comorbidities, socioeconomic factors, and site, to assess whether air pollution was associated with sleep apnea (apnea-hypopnea index ≥ 15) and actigraphy-measured sleep efficiency. RESULTS The participants (n = 1,974) were an average age of 68 (±9) years, 46% male, 36% white, 24% Hispanic, 28% black, and 12% Asian; 48% had sleep apnea and 25% had a sleep efficiency of ≤88%. A 10 ppb annual increase in NO2 exposure was associated with 39% greater adjusted odds of sleep apnea (95% confidence interval [CI], 1.03-1.87). A 5 μg/m3 greater annual PM2.5 exposure was also associated with 60% greater odds of sleep apnea (95% CI, 0.98-2.62). Sleep efficiency was not associated with air pollution levels in fully adjusted models. CONCLUSIONS Individuals with higher annual NO2 and PM2.5 exposure levels had a greater odds of sleep apnea. These data suggest that in addition to individual risk factors, environmental factors also contribute to the variation of sleep disorders across groups, possibly contributing to health disparities.
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40
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Meadows R, Nettleton S, Hine C, Ellis J. Counting sleep? Critical reflections on a UK national sleep strategy. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1744525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Robert Meadows
- Department of Sociology, University of Surrey, Surrey, UK
| | | | - Christine Hine
- Department of Sociology, University of Surrey, Surrey, UK
| | - Jason Ellis
- Department of Psychology, Northumbria University, Newcastle, UK
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Billings ME, Hale L, Johnson DA. Physical and Social Environment Relationship With Sleep Health and Disorders. Chest 2019; 157:1304-1312. [PMID: 31870910 DOI: 10.1016/j.chest.2019.12.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
Sleep health is a multidimensional construct that includes adequate duration, quality, and appropriately timed sleep that may be influenced by environmental factors. In this review, we focus on how an individual's living and sleeping environment, both the surrounding neighborhood physical and social features and the atmosphere around them, may impact their sleep health. We explore the associations of the physical environment (urban density, recreational facilities, green space, mixed land use, and healthy food stores), neighborhood deprivation (disadvantage and disorder), and the social environment (social cohesion, safety, and stigma) with sleep in both adult and pediatric populations. We investigate how physical and social environmental features may lead to alterations in the timing, duration, and quality of sleep and contribute to the most prevalent sleep disorders: insomnia, sleep apnea, and circadian rhythm disorders. We also review how ambient factors such as artificial light, environmental noise, and air pollution may contribute to sleep pathology. We have included key studies and recent emerging data regarding how the differential distribution of environmental factors that may affect sleep health may contribute to sleep health disparities.
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Affiliation(s)
- Martha E Billings
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Neighborhoods to Nucleotides - Advances and gaps for an obesity disparities systems epidemiology model. CURR EPIDEMIOL REP 2019; 6:476-485. [PMID: 36643055 PMCID: PMC9839192 DOI: 10.1007/s40471-019-00221-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Purpose of Review Disparities in obesity rates in the US continue to increase. Here we review progress and highlight gaps in understanding disparities in obesity with a focus on the Hispanic/Latino population from a systems epidemiology framework. We review seven domains: environment, behavior, biomarkers, nutrition, microbiome, genomics, and epigenomics/transcriptomics. We focus on recent advances that include at least two or more of these domains, and then provide a real world example of data collection efforts that reflect these domains. Recent Findings Research into DNA methylation related to discrimination and microbiome relating to eating behaviors and food content is furthering understanding of why disparities in obesity persist. Environmental and neighborhood level research is uncovering the importance of exposures such as air and noise pollution and systematic or structural racism for obesity and related outcomes through behaviors such as sleep.
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43
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Troxel WM, DeSantis A, Richardson AS, Beckman R, Ghosh-Dastidar B, Nugroho A, Hale L, Buysse DJ, Buman MP, Dubowitz T. Neighborhood disadvantage is associated with actigraphy-assessed sleep continuity and short sleep duration. Sleep 2019; 41:5054549. [PMID: 30016507 DOI: 10.1093/sleep/zsy140] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/13/2018] [Indexed: 12/30/2022] Open
Abstract
Study Objectives Neighborhood disadvantage has been linked to poor sleep. However, the extant research has primarily focused on self-reported assessments of sleep and neighborhood characteristics. The current study examines the association between objective and perceived neighborhood characteristics and actigraphy-assessed sleep duration, efficiency, and wakefulness after sleep onset (WASO) in an urban sample of African American adults. Methods We examined data from predominantly African American adults (n = 788, mean age 55 years; 77% female) living in two low-income neighborhoods. Perceived neighborhood characteristics included safety, social cohesion, and satisfaction with one's neighborhood as a place to live. Objective neighborhood conditions included walkability, disorder, street lighting, and crime levels. Sleep duration, efficiency, and WASO were measured via 7 days of wrist-worn actigraphy. Analyses estimated each of the sleep outcomes as a function of perceived and objective neighborhood characteristics. Individual-level sociodemographics, body mass index, and psychological distress were included as covariates. Results Greater perceived safety was associated with higher sleep efficiency and shorter WASO. Greater neighborhood disorder and street lighting were associated with poorer sleep efficiency and longer WASO and greater likelihood of short sleep duration (<7 versus 7-9 hr as referent). Higher levels of crime were associated with poorer sleep efficiency and longer WASO, but these associations were only evident in one of the neighborhoods. Conclusions Both how residents perceive their neighborhood and their exposure to objectively measured neighborhood disorder, lighting, and crime have implications for sleep continuity. These findings suggest that neighborhood conditions may contribute to disparities in sleep health.
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Affiliation(s)
| | - Amy DeSantis
- RAND Corporation, Health Division, Pittsburgh, PA
| | | | | | | | | | - Lauren Hale
- Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
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Vézina-Im LA, Lebel A, Gagnon P, Nicklas TA, Baranowski T. Individual Correlates of Sleep Among Childbearing Age Women in Canada. Behav Sleep Med 2019; 17:634-645. [PMID: 29436861 DOI: 10.1080/15402002.2018.1435547] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective/Background: Women of childbearing age (WOCBA) may be at high risk for short or poor sleep. Yet few studies have focused on this population. The study objective was to identify individual correlates of sleep duration and quality among WOCBA. Participants: The sample consisted of 9,749 WOCBA aged 18-44 years from the Canadian Community Health Survey 2011-2014. Methods: All variables were self-reported. Sleep duration was dichotomized as insufficient (< 7 hr/night) or adequate (≥ 7 hr/night). A composite score of sleep quality was dichotomized as having sleeping problems none/little or some/most/all the time. Age, ethnicity, level of education, household income, mood disorders, parity, geographical location, fruit and vegetable (FV) intake, physical activity, smoking and alcohol consumption were tested as correlates of sleep duration or quality using hierarchical logistic regression. Results: Ethnicity, parity, geographical location and smoking were correlates of sleep duration; this model discriminated 56.9% of WOCBA. Ethnic minorities, WOCBA with many children, living in urban areas and smoking were associated with lower odds of having adequate sleep duration. Ethnicity, level of education, mood disorders, geographical location, FV intake, and alcohol consumption were correlates of sleep quality; this model discriminated 59.0% of WOCBA. Ethnic minorities, lower level of education, mood disorders, living in urban areas, low FV intake, and alcohol consumption were associated with lower odds of having quality sleep. Conclusions: Some WOCBA may be more at risk for short or poor sleep based on their demographics and health behaviors. This can be used to identify which WOCBA are most in need of sleep interventions.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- a Children's Nutrition Research Center, Baylor College of Medicine , Houston , Texas , USA
| | - Alexandre Lebel
- b Graduate School of Urban Planning and Land Management, Laval University , Quebec City , Quebec , Canada.,c Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute , Quebec City , Quebec , Canada
| | - Pierre Gagnon
- c Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute , Quebec City , Quebec , Canada
| | - Theresa A Nicklas
- a Children's Nutrition Research Center, Baylor College of Medicine , Houston , Texas , USA
| | - Tom Baranowski
- a Children's Nutrition Research Center, Baylor College of Medicine , Houston , Texas , USA
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Hsieh YP, Lu WH, Yen CF. Psychosocial Determinants of Insomnia in Adolescents: Roles of Mental Health, Behavioral Health, and Social Environment. Front Neurosci 2019; 13:848. [PMID: 31447642 PMCID: PMC6696979 DOI: 10.3389/fnins.2019.00848] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/30/2019] [Indexed: 12/18/2022] Open
Abstract
The theoretical explanation of human problems is derived from the complex interplay of psychological, social, economic, political, and physical factors.
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Affiliation(s)
- Yi-Ping Hsieh
- Department of Social Work, University of North Dakota, College of Nursing and Professional Disciplines, Grand Forks, ND, United States
| | - Wei-Hsin Lu
- Department of Psychiatry, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital and School of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Johnson DA, Jackson CL, Williams NJ, Alcántara C. Are sleep patterns influenced by race/ethnicity - a marker of relative advantage or disadvantage? Evidence to date. Nat Sci Sleep 2019; 11:79-95. [PMID: 31440109 PMCID: PMC6664254 DOI: 10.2147/nss.s169312] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/09/2019] [Indexed: 12/25/2022] Open
Abstract
Sleep is a fundamental necessity of life. However, sleep health and sleep disorders are not equitably distributed across racial/ethnic groups. In fact, growing research consistently demonstrates that racial/ethnic minorities are more likely to experience, for instance, shorter sleep durations, less deep sleep, inconsistent sleep timing, and lower sleep continuity in comparison to Whites. However, racial/ethnic disparities in reports of sleepiness and sleep complaints are inconsistent. Racial/ethnic groups have significant heterogeneity, yet within-group analyses are limited. Among the few published within-group analyses, there are differences in sleep between non-US-born and US-born racial/ethnic groups, but the group with the more favorable sleep profile is consistent for non-US-born Latinos compared to US-born Latinos and Whites but unclear for other racial/ethnic minority groups. These sleep health disparities are a significant public health problem that should garner support for more observational, experimental, intervention, and policy/implementation research. In this review, we 1) summarize current evidence related to racial/ethnic disparities in sleep health and within-group differences, focusing on the sleep of the following racial/ethnic minority categories that are defined by the United States Office of Management and Budget as: American Indian/Alaska Native, Asian, African American/Black, Hispanic/Latino, and Native Hawaiian/Pacific Islander; 2) discuss measurement challenges related to investigating sleep health disparities; 3) discuss potential contributors to sleep health disparities; 4) present promising interventions to address sleep health disparities; and 5) discuss future research directions on intersectionality and sleep health.
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Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute on Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Department of Health and Human Services, Intramural Program, National Institute of Minority Health and Health Disparities, Bethesda, MD, USA
| | - Natasha J Williams
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY, USA
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Liou HYS, Kapur VK, Consens F, Billings ME. The Effect of Sleeping Environment and Sleeping Location Change on Positive Airway Pressure Adherence. J Clin Sleep Med 2018; 14:1645-1652. [PMID: 30353802 DOI: 10.5664/jcsm.7364] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/07/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Poor adherence undermines the effectiveness of positive airway pressure (PAP) therapy for sleep apnea. Disparities exist in PAP adherence by race/ethnicity and neighborhood socioeconomic status (SES), but the etiology of these differences is poorly understood. We investigated whether home environmental factors contribute to PAP adherence and whether identified factors explain disparities in adherence by SES. METHODS Adult patients with sleep apnea were surveyed at clinic visits about their sleep environment. Medical records were abstracted for demographic data, sleep apnea severity, comorbidities, and objective PAP adherence. We evaluated the association between aspects of home sleep environment with PAP adherence using multivariate linear and logistic regression, and assessed effect modification by SES factors. RESULTS Participants (n = 119) were diverse, with 44% nonwhite and 35% uninsured/Medicaid. After adjusting for age, sex, race/ethnicity, insurance, neighborhood SES, education, and marital status, participants who endorsed changing sleeping location once per month or more (18%, n = 21) had 77% lower odds of meeting PAP adherence criteria (> 4 h/night for 70% of nights) and less PAP use (median -11 d/mo, 95% confidence intervals -15.3, -6.5). Frequency of sleeping location change was the only environmental factor surveyed associated with PAP adherence. CONCLUSIONS Frequent change in sleeping location is associated with reduced PAP adherence, independent of sociodemographic factors. This novel finding has implications for physician-patient dialogue. PAP portability considerations in device selection and design may modify adherence and potentially improve treatment outcomes. Prospective investigation is needed to confirm this finding and inform design of possible interventions.
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Affiliation(s)
- Han Yu S Liou
- University of Washington School of Medicine, Seattle, Washington
| | - Vishesh K Kapur
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington
| | - Flavia Consens
- Department of Neurology, University of Washington, Seattle, Washington
| | - Martha E Billings
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington
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Xiao Q, Hale L. Neighborhood socioeconomic status, sleep duration, and napping in middle-to-old aged US men and women. Sleep 2018; 41:4985505. [PMID: 29697844 PMCID: PMC6047422 DOI: 10.1093/sleep/zsy076] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 03/05/2018] [Indexed: 12/20/2022] Open
Abstract
Study Objectives Earlier studies have linked neighborhood disadvantage with poor sleep outcomes. However, little is known about the association between changes in one's neighborhood over time and night sleep and napping. In over 300000 middle-to-old aged Americans, we examined neighborhood socioeconomic status (SES) and change in neighborhood SES in relation to nocturnal sleep duration and napping. Methods Nocturnal sleep duration and daytime napping were self-reported at baseline (1995-1996). Participants also reported baseline residential addresses, which were linked to US censuses. We derived a neighborhood SES index using census variables and calculated the baseline level and change (1990-2000) in neighborhood SES. Multinomial logistic regression was used to estimate the associations between neighborhood SES over time and nocturnal sleep and napping. Results Lower baseline neighborhood SES was associated with short sleep, long sleep, and napping. When compared with the highest quintile of neighborhood SES, the lowest was associated with 46% and 72% increase in relative risk (RR) of reporting very short (< 5 hours) sleep, 28% and 19% higher RR of long (≥9 hours) sleep and 95% and 85% increase in long (≥1 hours) nap in men and women, respectively. Moreover, a decrease in neighborhood SES was associated with higher RR of reporting very short sleep in women; while an improvement in neighborhood SES was associated with an increase in RR of long sleep in men. Conclusions Neighborhood disadvantage and worsening neighborhood conditions were associated with unhealthy sleep behaviors. These results reinforce a growing literature on the potential importance of neighborhood context for understanding sleep health.
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Affiliation(s)
- Qian Xiao
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY
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Johnson DA, Billings ME, Hale L. Environmental Determinants of Insufficient Sleep and Sleep Disorders: Implications for Population Health. CURR EPIDEMIOL REP 2018; 5:61-69. [PMID: 29984131 PMCID: PMC6033330 DOI: 10.1007/s40471-018-0139-y] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Sleep is important for overall health and well-being. Insufficient sleep and sleep disorders are highly prevalent among adults and children and therefore a public health burden, particularly because poor sleep is associated with adverse health outcomes. Emerging evidence has demonstrated that environmental factors at the household- and neighborhood-level can alter healthy sleep. This paper will (1) review recent literature on the environmental determinants of sleep among adults as well as children and adolescents; and (2) discuss the opportunities and challenges for advancing research on the environment and sleep. RECENT FINDINGS Epidemiologic research has shown that social features of environments, family, social cohesion, safety, noise, and neighborhood disorder can shape and/or impact sleep patterns; and physical features such as light, noise, traffic, pollution, and walkability can also influence sleep and is related to sleep disorders among adults and children. Prior research has mainly measured one aspect of the environment, relied on self-reported sleep, which does not correlate well with objective measures, and investigated cross-sectional associations. Although most studies are conducted among non-Hispanic white populations, there is growing evidence that indicates that minority populations are particularly vulnerable to the effects of the environment on insufficient sleep and sleep disorders. SUMMARY There is clear evidence that environmental factors are associated with insufficient sleep and sleep disorders. However, more research is warranted to evaluate how and which environmental factors contribute to sleep health. Interventions that target changes in the environment to promote healthy sleep should be developed, tested, and evaluated as a possible pathway for ameliorating sleep health disparities and subsequently health disparities.
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Affiliation(s)
- Dayna A. Johnson
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School
| | - Martha E. Billings
- Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Stony Brook University School of Medicine
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Ramos AR, Weng J, Wallace DM, Petrov MR, Wohlgemuth WK, Sotres-Alvarez D, Loredo JS, Reid KJ, Zee PC, Mossavar-Rahmani Y, Patel SR. Sleep Patterns and Hypertension Using Actigraphy in the Hispanic Community Health Study/Study of Latinos. Chest 2018; 153:87-93. [PMID: 28970105 PMCID: PMC5812757 DOI: 10.1016/j.chest.2017.09.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/19/2017] [Accepted: 09/06/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the association between actigraphy-based measures of sleep and prevalent hypertension in a sample of US Latinos. METHODS We analyzed data from 2,148 participants of the Sueño Sleep Ancillary Study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), who underwent 1 week of wrist actigraphy to characterize sleep duration, sleep efficiency, sleep fragmentation index, and daytime naps. Insomnia was defined as an Insomnia Severity Index ≥ 15. Hypertension was defined based on self-reported physician diagnosis. Survey linear regression was used to evaluate the association of sleep measures with hypertension prevalence. Sensitivity analyses excluded participants with an apnea-hypopnea index (AHI) ≥ 15 events/h. RESULTS The mean age was 46.3 ± 11.6 years, and 65% of the sample consisted of women. The mean sleep duration was 6.7 ± 1.1 hours. Thirty-two percent of the sample had hypertension. After adjusting for age, sex, ethnic background, site, and AHI, each 10% reduction in sleep efficiency was associated with a 7.5% (95% CI, -12.9 to -2.2; P = .0061) greater hypertension prevalence, each 10% increase in sleep fragmentation index was associated with a 5.2% (95% CI, 1.4-8.9; P = .0071) greater hypertension prevalence, and frequent napping was associated with a 11.6% greater hypertension prevalence (95% CI, 5.5-17.7; P = .0002). In contrast, actigraphy-defined sleep duration (P = .20) and insomnia (P = .17) were not associated with hypertension. These findings persisted after excluding participants with an AHI ≥ 15 events/h. CONCLUSIONS Independent of sleep-disordered breathing, we observed associations between reduced sleep continuity and daytime napping, but not short sleep duration, and prevalent hypertension.
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Affiliation(s)
- Alberto R Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL.
| | - Jia Weng
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Douglas M Wallace
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Neurology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL
| | - Megan R Petrov
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - William K Wohlgemuth
- Neurology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL; Psychology Service, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Jose S Loredo
- Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, CA
| | - Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, IL
| | - Phyllis C Zee
- Department of Neurology, Northwestern University, Chicago, IL
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Sanjay R Patel
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
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