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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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Aoun R, Zibara V, Costanian C, Attarian HP, Bahous SA. Sleep Medicine Knowledge Among Graduating Medical Students in Lebanon During an Economic and Political Crisis: A Preliminary Survey. Sleep Sci 2023; 16:e300-e309. [PMID: 38196759 PMCID: PMC10773503 DOI: 10.1055/s-0043-1772828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/09/2022] [Indexed: 01/11/2024] Open
Abstract
Objectives Sleep disorders are prevalent and underrecognized during both economic and political crises. They are a major reason for poor overall health and decreased quality of life. Sleep medicine education is limited at most medical schools, resulting in limited awareness of this important aspect of healthcare. The aim of the study is to assess sleep medicine knowledge of graduating medical students in Lebanon and to assess their readiness to tackle sleep health issues in a country during an unprecedented crisis. Methods Final-year medical students at 7 medical schools in Lebanon were invited to fill a survey between January 2020 and March 2021. The Assessment of Sleep Knowledge in Medical Education survey was used to assess their knowledge in sleep medicine. The curriculum organizers at the medical schools were also surveyed. Student's t -test was used for analysis. Results 158 and 58 students completed the survey during 2020 and 2021, with a mean overall score on sleep knowledge of was 17.5 and 15.9 /30, respectively. There was no difference in mean knowledge scores by gender, age, American versus European medical school systems, and between medical schools that included sleep medicine in their curriculum versus those that did not. Conclusions Presence of sleep medicine education in the curriculum was associated with higher scores on ASKME among graduating Lebanese medical students. Given the low response rate, however, this descriptive pilot data could be used as a launching pad for a larger study, with a more representative sample, for generalizable results.
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Affiliation(s)
- Raissa Aoun
- Department of Neurology, New York University Langone, New York, New York, United States
| | - Victor Zibara
- Department of Medicine, Lebanese American University, Gilbert and Rose-Marie Chaghoury School of Medicine, Byblos, Mount Lebanon, Lebanon
| | - Christy Costanian
- Department of Medicine, Lebanese American University, Gilbert and Rose-Marie Chaghoury School of Medicine, Byblos, Mount Lebanon, Lebanon
| | - Hrayr P. Attarian
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Sola Aoun Bahous
- Department of Medicine, Lebanese American University, Gilbert and Rose-Marie Chaghoury School of Medicine, Byblos, Mount Lebanon, Lebanon
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Grandner MA, Valencia DY, Seixas AA, Oliviér K, Gallagher RA, Killgore WDS, Hale L, Branas C, Alfonso-Miller P. Development and Initial Validation of the Assessment of Sleep Environment (ASE): Describing and Quantifying the Impact of Subjective Environmental Factors on Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13599. [PMID: 36294179 PMCID: PMC9602531 DOI: 10.3390/ijerph192013599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to develop and test the reliability and validity of a 13-item self-report Assessment of Sleep Environment (ASE). This study investigates the relationship between subjective experiences of environmental factors (light, temperature, safety, noise, comfort, humidity, and smell) and sleep-related parameters (insomnia symptoms, sleep quality, daytime sleepiness, and control over sleep). The ASE was developed using an iterative process, including literature searches for item generation, qualitative feedback, and pilot testing. It was psychometrically assessed using data from the Sleep and Healthy Activity Diet Environment and Socialization (SHADES) study (N = 1007 individuals ages 22-60). Reliability was determined with an internal consistency and factor analysis. Validity was evaluated by comparing ASE to questionnaires of insomnia severity, sleep quality, daytime sleepiness, sleep control, perceived stress, and neighborhood disorder. The ASE demonstrated high internal consistency and likely reflects a single factor. ASE score was associated with insomnia symptoms (B = 0.09, p < 0.0001), sleep quality (B = 0.07, p < 0.0001), and sleep control (B = -0.01, p < 0.0001), but not daytime sleepiness. The ASE was also associated with perceived stress (B = 0.20, p < 0.0001) and neighborhood disorder (B = -0.01, p < 0.0001). Among sleep environment factors, only smell was not associated with sleep quality; warmth and safety were negatively associated with sleepiness; and of the sleep environment factors, only light/dark, noise/quiet, and temperature (warm/cool) were not associated with insomnia symptoms. The ASE is a reliable and valid measure of sleep environment. Physical environment (light, temperature, safety, noise, comfort, humidity, and smell) was associated with insomnia symptoms and sleep quality but not sleepiness.
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Affiliation(s)
- Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Dora Y. Valencia
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Azizi A. Seixas
- Department of Population Health, NYU Langone Medical Center, New York, NY 10016, USA
| | - Kayla Oliviér
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Rebecca A. Gallagher
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY 11794, USA
| | - Charles Branas
- Department of Epidemiology, Columbia University, New York, NY 10032, USA
| | - Pamela Alfonso-Miller
- Northumbria Sleep Research, Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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Dubey S, Sahoo KC, Dash GC, Sahay MR, Mahapatra P, Bhattacharya D, del Barrio MO, Pati S. Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis. Front Public Health 2022; 10:1029394. [PMID: 36211702 PMCID: PMC9540216 DOI: 10.3389/fpubh.2022.1029394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 01/29/2023] Open
Abstract
The abysmal health of the urban poor or slum dwellers was attributed to structural inequities such as inadequate housing, water, and sanitation. This review aimed to assess housing-related opportunities and challenges during the COVID-19 pandemic among urban poor in low-and middle-income countries. For study identification, a comprehensive search was performed in 11 databases that yielded 22 potential studies. The inadequate housing infrastructure makes the lives of the urban poor more precarious during COVID-19. Typically, the houses lacked lighting, ventilation, and overcrowding. This review reflected that it is crucial to reimagine housing policy for the urban poor with an emphasis on pandemic/epidemic guidelines.
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Affiliation(s)
- Shubhankar Dubey
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Krushna Chandra Sahoo
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Girish Chandra Dash
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Pranab Mahapatra
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar, India
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Pathak N, Pollard KJ, McKinney A. Lifestyle Medicine Interventions for Personal and Planetary Health: The Urgent Need for Action. Am J Lifestyle Med 2022; 16:589-593. [PMID: 36072683 PMCID: PMC9442470 DOI: 10.1177/15598276221090887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The deterioration of planetary health—from threats such as climate change, environmental pollution, biodiversity loss, and ocean acidification—are a growing hazard to the foundation of health and the “healthspan.” For those with chronic conditions—a large and growing subset of the global population—the health dangers are even greater. Climate change is a threat to the very pillars of lifestyle medicine that we rely on to prevent and manage chronic disease. Already, the planetary crisis is limiting our ability to prescribe healthy nutrition, safe outdoor physical activity, stress management strategies, social connection, restorative sleep, and toxic substance avoidance. In this article, we discuss the proceedings of our workshop at the American College of Lifestyle Medicine (ACLM) annual conference LM2021, “Lifestyle Medicine for Personal and Planetary Health.” We examine how lifestyle medicine (LM) interventions are a prescription for individual, community, and planetary health. Our prescriptions work to not only restore the health of individuals and families, but also to bolster health equity while allowing us to mitigate and adapt to the health impacts of the planetary crises.
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Affiliation(s)
- Neha Pathak
- Global Sustainability Committee, American College of Lifestyle Medicine, Atlanta, GA, USA (NP)
- Global Sustainability Committee, American College of Lifestyle Medicine, Chesterfield, MO, USA (KJP)
- Global Sustainability Committee, American College of Lifestyle Medicine, USA (AM)
| | - Kathryn J. Pollard
- Global Sustainability Committee, American College of Lifestyle Medicine, Atlanta, GA, USA (NP)
- Global Sustainability Committee, American College of Lifestyle Medicine, Chesterfield, MO, USA (KJP)
- Global Sustainability Committee, American College of Lifestyle Medicine, USA (AM)
| | - Amanda McKinney
- Global Sustainability Committee, American College of Lifestyle Medicine, Atlanta, GA, USA (NP)
- Global Sustainability Committee, American College of Lifestyle Medicine, Chesterfield, MO, USA (KJP)
- Global Sustainability Committee, American College of Lifestyle Medicine, USA (AM)
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Koly KN, Khanam MI, Islam MS, Mahmood SS, Hanifi SMA, Reidpath DD, Khatun F, Rasheed S. Anxiety and Insomnia Among Urban Slum Dwellers in Bangladesh: The Role of COVID-19 and Its Associated Factors. Front Psychiatry 2021; 12:769048. [PMID: 34925097 PMCID: PMC8678050 DOI: 10.3389/fpsyt.2021.769048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Although mental health is an important part of health and wellbeing, very little is known about the impact of the COVID-19 pandemic on the mental health of marginalized communities like urban slum dwellers. Our study estimated the prevalence of generalized anxiety disorder and insomnia among the residents of the informal settlements of Dhaka, Bangladesh, during the COVID-19 pandemic. Methods: A cross-sectional phone-based survey was conducted from October to November 2020 among adult residents of five informal settlements of Dhaka city randomly chosen from an existing Urban Health and Demographic Surveillance Systems (UHDSS) run by icddr,b. Data on Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were collected. A multinomial logistic regression was performed to assess the associated factors of anxiety and insomnia. Results: Of the total 586 participants, the prevalence of mild to severe anxiety and insomnia were 53% and 43%, respectively. As per the multinomial regression analysis, participants with mild anxiety were significantly more likely to be older (>50 years) and afraid of COVID-19 infection. Likewise, participants with moderate/severe anxiety were significantly more likely to share less household facilities (e.g., toilet, kitchen, water) (OR: 2.23; 95% CI: 1.31-3.79), to have difficulties in food availability (OR: 2.76; 95% CI: 1.10-6.93), to be afraid of self (OR: 5.27; 95% CI: 2.82-9.88), and to worry about the family members (OR: 2.26; 95% CI: 1.23-4.17) getting infected. Participants with mild insomnia were significantly more likely to share fewer household facilities and be afraid of being infected with COVID-19 infection. Moreover, participants with moderate/severe insomnia were significantly more likely to be female (OR: 1.90; 95% CI: 1.02-3.56), to receive food aid (OR: 0.50; 95% CI: 0.29-0.88), to be afraid of self (OR: 3.85; 95% CI: 1.81-8.19), and to worry about someone like friends or neighbors (OR: 2.45; 95% CI: 1.07-5.58) getting infected with COVID-19. Conclusions: We found elevated prevalence of both anxiety and insomnia among the urban poor of Bangladesh in the context of COVID-19. This indicates the importance of integrating mental health in the mitigation and recovery efforts related to similar crises for the urban poor in the future.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Johnson DA, Jackson CL, Guo N, Sofer T, Laden F, Redline S. Perceived home sleep environment: associations of household-level factors and in-bed behaviors with actigraphy-based sleep duration and continuity in the Jackson Heart Sleep Study. Sleep 2021; 44:zsab163. [PMID: 34283244 PMCID: PMC8678916 DOI: 10.1093/sleep/zsab163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES In an older African-American sample (n = 231) we tested associations of the household environment and in-bed behaviors with sleep duration, efficiency, and wakefulness after sleep onset (WASO). METHODS Older adult participants completed a household-level sleep environment questionnaire, a sleep questionnaire, and underwent 7-day wrist actigraphy for objective measures of sleep. Perceived household environment (self-reported) was evaluated using questions regarding safety, physical comfort, temperature, noise, and light disturbances. In-bed behaviors included watching television, listening to radio/music, use of computer/tablet/phone, playing video games, reading books, and eating. To estimate the combined effect of the components in each domain (perceived household environment and in-bed behaviors), we calculated and standardized a weighted score per sleep outcome (e.g. duration, efficiency, WASO), with a higher score indicating worse conditions. The weights were derived from the coefficients of each component estimated from linear regression models predicting each sleep outcome while adjusting for covariates. RESULTS A standard deviation increase in an adverse household environment score was associated with lower self-reported sleep duration (β = -13.9 min, 95% confidence interval: -26.1, -1.7) and actigraphy-based sleep efficiency (β = -0.7%, -1.4, 0.0). A standard deviation increase in the in-bed behaviors score was associated with lower actigraphy-based sleep duration (β = -9.7 min, -18.0, -1.3), sleep efficiency (β = -1.2%, -1.9, -0.6), and higher WASO (5.3 min, 2.1, 8.6). CONCLUSION Intervening on the sleep environment, including healthy sleep practices, may improve sleep duration and continuity among African-Americans.
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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 of Environmental Health Sciences, National Institutes of Health, Triangle Park, NC, USA
- Intramural Program, Department of Health and Human Services, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Na Guo
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Cobb-Clark DA, Kettlewell N. Psychological, social and cognitive resources and the mental wellbeing of the poor. PLoS One 2021; 16:e0258417. [PMID: 34637477 PMCID: PMC8509876 DOI: 10.1371/journal.pone.0258417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/27/2021] [Indexed: 11/19/2022] Open
Abstract
Our study takes advantage of unique data to quantify deficits in the psychosocial and cognitive resources of an extremely vulnerable subpopulation–those experiencing housing vulnerability–in an advanced, high-income country (Australia). Groups such as these are often impossible to study using nationally representative data sources because they make up a small share of the overall population. We show that those experiencing housing vulnerability sleep less well, have more limited cognitive functioning, and less social capital than do those in the general population. They are also less emotionally stable, less conscientious, more external, and more risk tolerant. Collectively, these deficits in psychosocial and cognitive resources account for between 24–42% of their reduced life satisfaction and their increased mental distress and loneliness. These traits also account for a large proportion of the gap in mental wellbeing across different levels of housing vulnerability.
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Affiliation(s)
- Deborah A. Cobb-Clark
- School of Economics, The University of Sydney, Sydney, NSW, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, School of Economics, The University of Sydney, Sydney, NSW, Australia
- Institute of Labor Economics (IZA), University of Bonn, Bonn, Germany
| | - Nathan Kettlewell
- ARC Centre of Excellence for Children and Families over the Life Course, School of Economics, The University of Sydney, Sydney, NSW, Australia
- Institute of Labor Economics (IZA), University of Bonn, Bonn, Germany
- Economics Discipline Group, University of Technology Sydney, Sydney, NSW, Australia
- * E-mail:
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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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10
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Skevington SM. Is Culture Important to the Relationship Between Quality of Life and Resilience? Global Implications for Preparing Communities for Environmental and Health Disasters. Front Psychol 2020; 11:1492. [PMID: 32852482 PMCID: PMC7406707 DOI: 10.3389/fpsyg.2020.01492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/04/2020] [Indexed: 01/15/2023] Open
Abstract
Background Using a preventative approach, we investigated whether international subjective qualities of life are associated with resilience to adversity when culture is taken into account. Although resilience has been previously associated with good QoL, cross-cultural studies are scarce. Methods Sequential linear multiple regression models of WHOQOL SRPB data from 15 countries worldwide (N = 3,019) examined which qualities are most closely associated with resilience, when adjusting for culture and selected demographics. We also examined whether all cultures confirmed this positive association. Of 13 QoL facets identified from a literature summary, seven were associated with defining resilience and six reflected strategies for building resilience; these were tested together. Principal components analysis provided a dependent variable for resilience, covering inner strength and hope. Results The final model explained 52% of resilience overall, of which QoL explained 37% and culture explained 12% (p < 0.0001). Being older than 45 years was a significant covariate. Spiritual QoL from meaning in life, awe and wonder, wholeness and integration, and being kind to others was linked with strategies for building resilience (28%). Better psychological QoL from high levels of positive feelings and low negative feelings was associated with defining resilience (9%). Larger significant positive β’s were found for 10 cultures, so model “universality” was not confirmed. Conclusion A new cross-cultural psycho-spiritual model of resilience is presented. Assessing individual QoL profiles could identify suitable community members to build resilience locally in culturally acceptable styles. The WHOQOL SRPB evidence could inform international policy designed to prepare vulnerable cultures that are threatened with environmental and health disasters.
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Affiliation(s)
- Suzanne M Skevington
- Manchester Centre for Health Psychology, Division of Psychological Science and Mental Health, The University of Manchester, Manchester, United Kingdom
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11
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Seixas AA, Moore J, Chung A, Robbins R, Grandner M, Rogers A, Williams NJ, Jean-Louis G. Benefits of Community-Based Approaches in Assessing and Addressing Sleep Health and Sleep-Related Cardiovascular Disease Risk: a Precision and Personalized Population Health Approach. Curr Hypertens Rep 2020; 22:52. [PMID: 32671477 DOI: 10.1007/s11906-020-01051-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW In this current review, we describe the benefits of community-based and "precision and personalized population health" (P3H) approaches to assessing and addressing sleep health problems and sleep-related cardiovascular diseases (CVD) among vulnerable populations such as racial/ethnic minorities, the elderly, and the socioeconomically disadvantaged. RECENT FINDINGS Very few sleep health programs utilize a community-based or P3H approach, which may account for low estimates of sleep health problems, related CVD outcomes, and inadequate healthcare infrastructure to address sleep-related health outcomes at the community and population level. We describe community-based and P3H approaches and programs as solutions to accurately capture estimates of sleep health and reduce burden of sleep health problems and corollary CVD outcomes at the level of the community and population. Specifically, we describe seven critical steps needed to successfully implement a community-based and P3H approach to address sleep health problems. Community-based and P3H approaches are effective strategies to assessing and addressing sleep health problems and related health conditions.
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Affiliation(s)
- Azizi A Seixas
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA. .,Department of Psychiatry, NYU Langone Health, 180 Park Avenue, New York, NY, 10016, USA.
| | - Jesse Moore
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA
| | - Alicia Chung
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA
| | - Rebecca Robbins
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michael Grandner
- University of Arizona College of Medicine, Tucson, AZ, 85721, USA
| | | | - Natasha J Williams
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA
| | - Girardin Jean-Louis
- Department of Population Health, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA.,Department of Psychiatry, NYU Langone Health, 180 Park Avenue, New York, NY, 10016, USA
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12
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Henson RM, Ortigoza A, Martinez-Folgar K, Baeza F, Caiaffa W, Vives Vergara A, Diez Roux AV, Lovasi G. Evaluating the health effects of place-based slum upgrading physical environment interventions: A systematic review (2012-2018). Soc Sci Med 2020; 261:113102. [PMID: 32739786 PMCID: PMC7611465 DOI: 10.1016/j.socscimed.2020.113102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 11/04/2022]
Abstract
Rapid urbanization in low- and middle-income countries (LMIC) is associated with increasing population living in informal settlements. Inadequate infrastructure and disenfranchisement in settlements can create environments hazardous to health. Placed-based physical environment upgrading interventions have potential to improve environmental and economic conditions linked to health outcomes. Summarizing and assessing evidence of the impact of prior interventions is critical to motivating and selecting the most effective upgrading strategies moving forward. Scientific and grey literature were systematically reviewed to identify evaluations of physical environment slum upgrading interventions in LMICs published between 2012 and 2018. Thirteen evaluations that fulfilled inclusion criteria were reviewed. Quality of evaluations was assessed using an adapted Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Findings were then pooled with those published prior to 2012. Narrative analysis was performed. Of thirteen evaluations, eight used a longitudinal study design (“primary evaluations”). All primary evaluations were based in Latin America and included two housing, two transportation, and four comprehensive intervention evaluations. Three supporting evaluations assessed housing interventions in Argentina and South Africa; two assessed a comprehensive intervention in India. Effects by intervention-type included improvements in quality of life and communicable diseases after housing interventions, possible improvements in safety after transportation and comprehensive interventions, and possible non-statistically significant effects on social capital after comprehensive interventions. Effects due to interventions may vary by regional context and intervention scope. Limited strong evidence and the diffuse nature of comprehensive interventions suggests a need for attention to measurement of intervention exposure and analytic approaches to account for confounding and selection bias in evaluation. In addition to health improvements, evaluators should consider unintended health consequences and environmental impact. Understanding and isolating the effects of place-based interventions can inform necessary policy decisions to address inadequate living conditions as rapid urban growth continues across the globe.
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Affiliation(s)
- Rosie Mae Henson
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104.
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
| | - Kevin Martinez-Folgar
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104; Instituto de Nutrición de Centroamérica y Panamá (INCAP), Guatemala
| | - Fernando Baeza
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Waleska Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Brazil
| | - Alejandra Vives Vergara
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile; Centro de Desarrollo Urbano Sustentable (CEDEUS), Pontificia Universidad Católica de Chile, Chile
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
| | - Gina Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
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Shin JC, Parab KV, An R, Grigsby-Toussaint DS. Greenspace exposure and sleep: A systematic review. ENVIRONMENTAL RESEARCH 2020; 182:109081. [PMID: 31891829 DOI: 10.1016/j.envres.2019.109081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/18/2019] [Accepted: 12/21/2019] [Indexed: 05/23/2023]
Abstract
Green space is considered a critical environmental factor for sleep quality and quantity. However, no systematic review exploring this relationship exists. The purpose of this systematic review was to 1) explore research related to green space and sleep, and 2) examine the impact of green space exposure on sleep quality and quantity. Papers from eight electronic databases were eligible for inclusion if they met the following criteria: well-designed, any analysis exploring green space and sleep, provided sleep and green space measurement, published in peer-reviewed journals, and written in English. Thirteen eligible studies related to green space and sleep were selected after peer-review procedures. Cross-sectional studies (n = 7) used either a questionnaire or the combination of Geographic Information Systems and remote sensing images for green space measurement, while questionnaires were primarily used to measure both sleep quality and quantity. Intervention studies (n = 5) were categorized into three types: walking program, gardening, and working in a forest. Eleven out of thirteen studies concluded that green space exposure was associated with improvement in both sleep quality and quantity. The findings support the evidence of a positive association between green space exposures and sleep quality and quantity, and also suggest green exercise and therapeutic gardening as possible intervention methods to improve sleep outcomes.
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Affiliation(s)
- Jong Cheol Shin
- Department Behavioral and Social Sciences, Center for Health Equity Research, Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, RI, USA.
| | - Kaustubh Vijay Parab
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | - Ruopeng An
- Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - Diana S Grigsby-Toussaint
- Department Behavioral and Social Sciences, Center for Health Equity Research, Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, RI, USA.
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Rubens SL, Gudiño OG, Ford LM, Soliemannjad RR, Contreras PD. Association between the sleep environment and sleep problems in low-income Latinx youth. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1727323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sonia L. Rubens
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | - Omar G. Gudiño
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Loren M. Ford
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | - Rose R. Soliemannjad
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | - Paloma D. Contreras
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
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15
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Rubens SL, Miller MA, Zeringue MM. The sleep environment and its association with externalizing behaviors in a sample of low-income adolescents. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:628-640. [PMID: 30447003 DOI: 10.1002/jcop.22142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 06/09/2023]
Abstract
This study examined the sleep environment and its association with externalizing problems in adolescents attending an alternative high school. Participants included 114 students (56% female, 91% Black, mean age = 18.03, standard deviation [SD] = 1.49) from an alternative high school in a southeastern city. Most participants reported sleeping in a bed (83%) and at their house (72%) for 7 nights in the past week. Participants reported an average of 2.34 (SD = 1.86) past-week ambient sleep disruptions. Sleeping fewer nights in their own home and experiencing higher levels of ambient sleep disruptions were associated with delinquency engagement. Fewer nights sleeping in a bed and higher levels of ambient sleep disruptions were associated with a significant arrest history. The sleep environment is important to consider when assessing sleep problems, particularly among low-income adolescents living in urban environments. This information may inform comprehensive interventions to address behavioral health concerns.
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Schokman A, Bin YS, Simonelli G, Pye J, Morris R, Sumathipala A, Siribaddana SH, Hotopf M, Rijsdijk F, Jayaweera K, Glozier N. Agreement between subjective and objective measures of sleep duration in a low-middle income country setting. Sleep Health 2018; 4:543-550. [DOI: 10.1016/j.sleh.2018.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/24/2018] [Accepted: 08/30/2018] [Indexed: 01/01/2023]
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Johnson BS, Malecki KM, Peppard PE, Beyer KMM. Exposure to neighborhood green space and sleep: evidence from the Survey of the Health of Wisconsin. Sleep Health 2018; 4:413-419. [PMID: 30241655 PMCID: PMC6152838 DOI: 10.1016/j.sleh.2018.08.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/11/2018] [Accepted: 08/01/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Adequate sleep duration and quality are protective against many adverse health outcomes. Many individual-level predictors of poor sleep have been examined, but few studies have examined neighborhood-level influences. Despite known associations between neighborhood green space and sleep influencing factors (eg, physical activity, mental health), few studies have examined green space and sleep's relationship. Furthermore, little work has examined the relationship between the magnitude and type of neighborhood sounds and sleep. STUDY METHODS We analyzed data from the Survey of the Health of Wisconsin database (n = 2712) for 2008-2013, a representative sample of Wisconsin residents ages 21-74. Outcomes included weekday and weekend sleep duration and self-rated sleep quality. Primary predictors were the proportion tree canopy (National Land Cover Database) and mean decibel levels of outdoor sound (US National Park Service) at the census block group level. Survey regression analysis was used to examine statistical associations, controlling for individual and neighborhood-level covariates. RESULTS Models suggest a significant relationship (P < .05) between weekday sleep duration and green space, and between weekend/day sleep duration and human-made and total neighborhood sound. Increased percent tree canopy in a census block group was associated with lower odds of short weekday sleep (<6 hours) (OR 0.76 [0.58-0.98]). Increased human-made and total mean decibel levels were associated with increased instances of short weekend and weekday sleep (OR 1.05 [1.01-1.08] and 1.03 [1.01-1.06] respectively). CONCLUSIONS Neighborhood tree canopy and sound levels may influence sleep duration and are potential targets for neighborhood-level interventions to improve sleep.
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Affiliation(s)
- Benjamin S. Johnson
- School of Medicine, Medical College of Wisconsin, 8701
Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Kristen M. Malecki
- School of Medicine and Public Health and Survey of the
Health of Wisconsin, University of Wisconsin-Madison, Wisconsin Alumni Research
Foundation, 610 Walnut St., Madison, WI 53726, USA;
| | - Paul E. Peppard
- School of Medicine and Public Health and Survey of the
Health of Wisconsin, University of Wisconsin-Madison, Wisconsin Alumni Research
Foundation, 610 Walnut St., Madison, WI 53726, USA;
| | - Kirsten M. M. Beyer
- Division of Epidemiology, Institute for Health and Equity,
Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
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Simonelli G, Marshall NS, Grillakis A, Miller CB, Hoyos CM, Glozier N. Sleep health epidemiology in low and middle-income countries: a systematic review and meta-analysis of the prevalence of poor sleep quality and sleep duration. Sleep Health 2018; 4:239-250. [DOI: 10.1016/j.sleh.2018.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/01/2018] [Accepted: 03/05/2018] [Indexed: 12/30/2022]
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Johnson DA, Thorpe RJ, McGrath JA, Jackson WB, Jackson CL. Black-White Differences in Housing Type and Sleep Duration as Well as Sleep Difficulties in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E564. [PMID: 29561769 PMCID: PMC5923606 DOI: 10.3390/ijerph15040564] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/10/2018] [Accepted: 03/16/2018] [Indexed: 11/16/2022]
Abstract
Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004-2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02-1.08)) and women (PR = 1.07 (95% CI: 1.04-1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21-1.30)) and women (PR = 1.24 (95% CI: 1.20-1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race-sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities.
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Affiliation(s)
- Dayna A Johnson
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02131, USA.
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - John A McGrath
- Social & Scientific Systems, Inc., Research Triangle Park, NC 27709, USA.
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., Research Triangle Park, NC 27709, USA.
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, NC 27709, USA.
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Skevington SM, Epton T. How will the sustainable development goals deliver changes in well-being? A systematic review and meta-analysis to investigate whether WHOQOL-BREF scores respond to change. BMJ Glob Health 2018; 3:e000609. [PMID: 29379649 PMCID: PMC5759710 DOI: 10.1136/bmjgh-2017-000609] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 11/26/2022] Open
Abstract
Introduction The Sustainable Development Goals (SDGs) 2015 aim to ‘…promote well-being for all’, but this has raised questions about how its targets will be evaluated. A cross-cultural measure of subjective perspectives is needed to complement objective indicators in showing whether SDGs improve well-being. The WHOQOL-BREF offers a short, generic, subjective quality of life (QoL) measure, developed with lay people in 15 cultures worldwide; 25 important dimensions are scored in environmental, social, physical and psychological domains. Although validity and reliability are demonstrated, clarity is needed on whether scores respond sensitively to changes induced by treatments, interventions and major life events. We address this aim. Methods The WHOQOL-BREF responsiveness literature was systematically searched (Web of Science, PubMed, EMBASE and Medline). From 117 papers, 15 (24 studies) (n=2084) were included in a meta-analysis. Effect sizes (Cohen’s d) assessed whether domain scores changed significantly during interventions/events, and whether such changes are relevant and meaningful to managing clinical and social change. Results Scores changed significantly over time on all domains: small to moderate for physical (d=0.37; CI 0.25 to 0.49) and psychological QoL (d=0.22; CI 0.14 to 0.30), and small for social (d=0.10; CI 0.05 to 0.15) and environmental QoL (d=0.12; CI 0.06 to 0.18). More importantly, effect size was significant for every domain (p<0.001), indicating clinically relevant change, even when differences are small. Domains remained equally responsive regardless of sample age, gender and evaluation interval. Conclusion International evidence from 11 cultures shows that all WHOQOL-BREF domains detect relevant, meaningful change, indicating its suitability to assess SDG well-being targets.
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Affiliation(s)
- Suzanne M Skevington
- International Hub for Quality of Life Research, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Tracy Epton
- International Hub for Quality of Life Research, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK
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Ruff RR, Ng J, Jean-Louis G, Elbel B, Chaix B, Duncan DT. Neighborhood Stigma and Sleep: Findings from a Pilot Study of Low-Income Housing Residents in New York City. Behav Med 2018; 44:48-53. [PMID: 27492685 DOI: 10.1080/08964289.2016.1203754] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The primary objective of this study was to investigate the relationship between neighborhood stigma and sleep in a sample of low-income housing residents in New York City. Data were derived from the NYC Low-Income Housing, Neighborhoods, and Health Study (N = 120). Adults living in low-income housing completed a survey consisting of measures of neighborhood stigma, sleep quality, and sleep duration. Neighborhood stigma and sleep were self-reported. Associations between neighborhood stigma and sleep health were analyzed using generalized linear models with cluster variance estimation. Multivariable models adjusted for age, gender, race/ethnicity, income, education, employment status, obesity, the census block percentage of non-Hispanic black residents, and the census block percentage median household income. Results indicate that a reported negative media perception of the neighborhood was negatively associated with sleep quality and duration (p < 0.01). However, additional research is needed to explore neighborhood stigma as it relates to sleep.
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Affiliation(s)
- Ryan Richard Ruff
- a New York University College of Dentistry and New York University College of Global Public Health
| | - Jeannie Ng
- b New York University College of Global Public Health
| | | | - Brian Elbel
- d New York University School of Medicine and New York University Wagner Graduate School of Public Service
| | - Basile Chaix
- e Sorbonne Universités and Pierre Louis Institute of Epidemiology and Public Health
| | - Dustin T Duncan
- f New York University School of Medicine, New York University College of Global Public Health, and New York University Center for Data Science
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22
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Smoking, Screen-Based Sedentary Behavior, and Diet Associated with Habitual Sleep Duration and Chronotype: Data from the UK Biobank. Ann Behav Med 2017; 50:715-726. [PMID: 27056396 DOI: 10.1007/s12160-016-9797-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Sleep duration has been implicated in the etiology of obesity but less is known about the association between sleep and other behavioral risk factors for cardiovascular disease. PURPOSE The aim of this study was to examine the associations among sleep duration, chronotype, and physical activity, screen-based sedentary behavior, tobacco use, and dietary intake. METHODS Regression models were used to examine sleep duration and chronotype as the predictors and cardiovascular risk factors as outcomes of interest in a cross-sectional sample of 439,933 adults enrolled in the UK Biobank project. RESULTS Short sleepers were 45 % more likely to smoke tobacco than adequate sleepers (9.8 vs. 6.9 %, respectively). Late chronotypes were more than twice as likely to smoke tobacco than intermediate types (14.9 vs. 7.4 %, respectively). Long sleepers reported 0.61 more hours of television per day than adequate sleepers. Early chronotypes reported 0.20 fewer daily hours of computer use per day than intermediate chronotypes. Early chronotypes had 0.25 more servings of fruit and 0.13 more servings of vegetables per day than late chronotypes. CONCLUSIONS Short and long sleep duration and late chronotype are associated with greater likelihood of cardiovascular risk behaviors. Further work is needed to determine whether these findings are maintained in the context of objective sleep and circadian estimates, and in more diverse samples. The extent to which promoting adequate sleep duration and earlier sleep timing improves heart health should also be examined prospectively.
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Romanzini LP, Dos Santos AÁ, Nunes ML. Characteristics of sleep in socially vulnerable adolescents. Eur J Paediatr Neurol 2017; 21:627-634. [PMID: 28284888 DOI: 10.1016/j.ejpn.2016.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 12/20/2016] [Accepted: 12/29/2016] [Indexed: 11/19/2022]
Abstract
IMPORTANCE This study may help understand the effects of an unfavorable environment in sleep quality of adolescents. OBJECTIVE To investigate sleep quality in socially vulnerable adolescents, correlating the results with cognitive problems and attention deficit/hyperactivity disorder, and assessing the effectiveness of sleep hygiene and an educational intervention. DESIGN Cross-sectional and interventional study. SETTING an educational charitable center supported by a Catholic institution, in Porto Alegre, southern Brazil. PARTICIPANTS 125 male and female high school students. INTERVENTIONS As first step the subjects were administered specific questionnaires, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), followed by an educational activity that was combined with an unblinded, randomized interventional study. Next, a cross-sectional study was conducted to determine the influence of cognition and ADHD on the sleep. MAIN OUTCOME AND MEASURES Sleep was evaluated using PSQI and ESS. Cognitive assessment was based on the Wechsler Abbreviated Scale of Intelligence and ADHD by a clinical interview the Multimodal Treatment Study for ADHD (MTA-SNAP-IV). RESULTS The average duration of sleep per night were 6 h 30 m. 80% of the sample presented sleep complains. Of these, 44% had excessive daytime sleepiness and 69.6% had poor sleep quality related to use of electronic media, environmental violence, and emotional issues. There were no significant associations between sleep problems and cognitive problems or ADHD. Sleep quality improved in 17% of the 53 students with previous sleep complains who participated in any of the two interventions. CONCLUSIONS A high prevalence of sleep deprivation and sleep complains was found in the study sample. The interventions showed some positive effects on the improvement of sleep quality.
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Affiliation(s)
- Lisie Polita Romanzini
- Graduate Program of Medicine and Health Sciences, Pontificia Universidade Católica do Rio Grande do Sul, Brazil.
| | - Aline Ávila Dos Santos
- Graduate Program of Medicine and Health Sciences, Pontificia Universidade Católica do Rio Grande do Sul, Brazil.
| | - Magda Lahorgue Nunes
- School of Medicine and Brain Institute (BraIns), Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
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Simonelli G, Dudley KA, Weng J, Gallo LC, Perreira K, Shah NA, Alcantara C, Zee PC, Ramos AR, Llabre MM, Sotres-Alvarez D, Wang R, Patel SR. Neighborhood Factors as Predictors of Poor Sleep in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos. Sleep 2017; 40:2661544. [PMID: 28364454 PMCID: PMC5804993 DOI: 10.1093/sleep/zsw025] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Study Objectives To evaluate whether an adverse neighborhood environment has higher prevalence of poor sleep in a US Hispanic/Latino population. Methods A cross-sectional analysis was performed in 2156 US Hispanic/Latino participants aged 18-64 years from the Sueño ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Participants completed surveys of neighborhood environment including perceived safety, violence and noise, the Insomnia Severity Index (ISI), and 7 days of wrist actigraphy. Results In age and sex-adjusted analyses, short sleep, low sleep efficiency, and late sleep midpoint were all more prevalent among those living in an unsafe neighborhood. After adjustment for background, site, nativity, income, employment, depressive symptoms, and sleep apnea, the absolute risk of sleeping <6 hours was 7.7 (95% CI [0.9, 14.6]) percentage points greater in those living in an unsafe compared to a safe neighborhood. There were no differences in the prevalence of insomnia by level of safety or violence. Insomnia was more prevalent among those living in a noisy neighborhood. In adjusted analysis, the absolute risk of insomnia was 4.4 (95% CI [0.4, 8.4]) percentage points greater in those living in noisy compared to non-noisy neighborhoods. Conclusion Using validated measures of sleep duration and insomnia, we have demonstrated the existence of a higher prevalence of short sleep and insomnia by adverse neighborhood factors. An adverse neighborhood environment is an established risk factor for a variety of poor health outcomes. Our findings suggest negative effects on sleep may represent one pathway by which neighborhood environment influences health.
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Affiliation(s)
- Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Katherine A Dudley
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jia Weng
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Linda C Gallo
- Department of Psychology San Diego State University, San Diego, CA
| | - Krista Perreira
- Department of Public Policy, University of North Carolina, Chapel Hill, NC
| | - Neomi A Shah
- Division of Pulmonary, Critical Care and Sleep, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Evanston, IL
| | - Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Rui Wang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
| | - Sanjay R Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
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25
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Tomayko EJ, Flood TL, Tandias A, Hanrahan LP. Linking electronic health records with community-level data to understand childhood obesity risk. Pediatr Obes 2015; 10:436-41. [PMID: 25559099 PMCID: PMC4492911 DOI: 10.1111/ijpo.12003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/08/2014] [Accepted: 10/26/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Environmental and socioeconomic factors should be considered along with individual characteristics when determining risk for childhood obesity. OBJECTIVES To assess relationships and interactions among the economic hardship index (EHI) and race/ethnicity, age and sex in regard to childhood obesity rates in Wisconsin children using an electronic health record dataset. METHODS Data were collected using the University of Wisconsin (UW) Public Health Information Exchange database, which links electronic health records with census-derived community-level data. Records from 53,775 children seen at UW clinics from 2007 to 2012 were included. Mixed-effects modelling was used to determine obesity rates and the interaction of EHI with covariates (race/ethnicity, age, sex). When significant interactions were determined, linear regression analyses were performed for each subgroup (e.g. by age groups). RESULTS The overall obesity rate was 11.7% and significant racial/ethnic disparities were detected. Childhood obesity was significantly associated with EHI at the community level (r = 0.62, P < 0.0001). A significant interaction was determined between EHI and both race/ethnicity and age on obesity rates. CONCLUSIONS Reducing economic disparities and improving environmental conditions may influence childhood obesity risk in some, but not all, races and ethnicities. Furthermore, the impact of EHI on obesity may be compounded over time. Our findings demonstrate the utility of linking electronic health information with census data to rapidly identify community-specific risk factors in a cost-effective manner.
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Affiliation(s)
- Emily J. Tomayko
- University of Wisconsin, College of Agricultural & Life Sciences; Department of Nutritional Sciences; 1415 Linden Drive Madison, WI 53706
| | - Tracy L. Flood
- University of Wisconsin, School of Medicine and Public Health; Department of Population Health Sciences; 610 North Walnut Street Madison, WI 53726
| | - Aman Tandias
- University of Wisconsin School of Medicine and Public Health; Department of Family Medicine; 1100 Delaplaine Ct. Madison, WI 53715
| | - Lawrence P. Hanrahan
- University of Wisconsin School of Medicine and Public Health; Department of Family Medicine; 1100 Delaplaine Ct. Madison, WI 53715,Corresponding author: Lawrence P. Hanrahan, PhD, MS, Research Director and PHINEX PI, Department of Family Medicine, University of Wisconsin School of Medicine and Public Health; 1100 Delaplaine Ct. Madison, WI 53715; 608-263-5846 (phone); 608-263-5813 (fax);
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26
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Patel SR, Sotres-Alvarez D, Castañeda SF, Dudley KA, Gallo LC, Hernandez R, Medeiros EA, Penedo FJ, Mossavar-Rahmani Y, Ramos AR, Redline S, Reid KJ, Zee PC. Social and Health Correlates of Sleep Duration in a US Hispanic Population: Results from the Hispanic Community Health Study/Study of Latinos. Sleep 2015; 38:1515-22. [PMID: 26085298 DOI: 10.5665/sleep.5036] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Indexed: 01/25/2023] Open
Abstract
STUDY OBJECTIVES To define the prevalence of poor sleep patterns in the US Hispanic/Latino population, identify sociodemographic and psychosocial predictors of short and long sleep duration, and the association between sleep and cardiometabolic outcomes. DESIGN Cross-sectional analysis. SETTING Community-based study. PARTICIPANTS Adults age 18-74 y free of sleep disorders (n = 11,860) from the Hispanic Community Health Study/Study of Latinos baseline examination (2008-2011). INTERVENTIONS N/A. MEASUREMENTS AND RESULTS The mean self-reported sleep duration was 8.0 h per night with 18.6% sleeping less than 7 h and 20.1% sleeping more than 9 h in age- and sex-adjusted analyses. Short sleep was most common in individuals of Puerto Rican heritage (25.6%) and the Other Hispanic group (27.4%). Full-time employment, low level of education, and depressive symptoms were independent predictors of short sleep, whereas unemployment, low household income, low level of education, and being born in the mainland US were independent predictors of long sleep. After accounting for sociodemographic differences, short sleep remained significantly associated with obesity with an odds ratio of 1.29 [95% confidence interval 1.12-1.49] but not with diabetes, hypertension, or heart disease. In contrast, long sleep was not associated with any of these conditions. CONCLUSIONS Sleep duration is highly variable among US Hispanic/Latinos, varying by Hispanic/Latino heritage as well as socioeconomic status. These differences may have health consequences given associations between sleep duration and cardiometabolic disease, particularly obesity.
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Affiliation(s)
- Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | | | | | - Katherine A Dudley
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | | | | | | | | | | | | | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
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27
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Mukherjee S, Patel SR, Kales SN, Ayas NT, Strohl KP, Gozal D, Malhotra A. An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities. Am J Respir Crit Care Med 2015; 191:1450-8. [PMID: 26075423 DOI: 10.1164/rccm.201504-0767st] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Despite substantial public interest, few recommendations on the promotion of good sleep health exist to educate health care providers and the general public on the importance of sleep for overall health. OBJECTIVES The aim of this American Thoracic Society (ATS) statement is to provide a review of the current scientific literature to assist health care providers, especially pulmonologists and sleep physicians, in making recommendations to patients and the general public about the importance of achieving good quality and adequate quantity of sleep. METHODS ATS members were invited, based on their expertise in sleep medicine, and their conclusions were based on both empirical evidence identified after comprehensive literature review and clinical experience. MAIN RESULTS We focus on sleep health in both children and adults, including the impact of occupation on sleep, the public health implications of drowsy driving, and the common sleep disorders of obstructive sleep apnea and insomnia. This ATS statement also delineates gaps in research and knowledge that should be addressed and lead to new focused research priorities to advance knowledge in sleep and sleep health. CONCLUSIONS Good quality and quantity of sleep are essential for good health and overall quality of life; therefore a strong recommendation was made for the implementation of public education programs on the importance of sleep health.
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28
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Simonelli G. Perceived neighborhood safety and sleep, commentary on the association of neighborhood characteristics with sleep duration and daytime sleepiness. Sleep Health 2015; 1:156-157. [PMID: 29073436 DOI: 10.1016/j.sleh.2015.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 07/07/2015] [Accepted: 07/08/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Guido Simonelli
- Behavioral Biology Branch, Center For Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD.
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29
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Simonelli G, Patel SR, Rodríguez-Espínola S, Pérez-Chada D, Salvia A, Cardinali DP, Vigo DE. The impact of home safety on sleep in a Latin American country. Sleep Health 2015; 1:98-103. [PMID: 29073385 DOI: 10.1016/j.sleh.2015.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/13/2015] [Accepted: 02/16/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We sought to assess the impact of feelings of safety in one's neighborhood and home on sleep quality and sleep duration. DESIGN The design is a cross-sectional survey using face-to-face interviews, as part of the Argentine Social Debt Observatory assessment. SETTING The setting is a nationwide data from Argentina. PARTICIPANTS There are 5636 participants aged 18 years and older. INTERVENTION (IF ANY) N/A. MEASUREMENTS The relationships between both subjective sleep quality and self-reported sleep duration, categorized as short (<7 hours), normal (7-8 hours), and long (>8 hours) with safety in one's neighborhood and one's home, were analyzed. Age, sex, obesity, neighborhood socioeconomic status, and education were included as covariates. RESULTS Feeling unsafe in one's home was strongly associated with poorer sleep quality and with short sleep duration. Feeling unsafe in one's neighborhood was initially associated with reduced sleep quality but was no longer significant after controlling for home safety. In contrast, we found no correlation between safety measures and long sleep. In analyses stratified by sex, feeling unsafe in one's home was associated with poor sleep quality in women but not in men. CONCLUSIONS Our findings suggest that safety in the home has an important effect on both sleep quality and duration, particularly among women. In contrast, after accounting for safety in the home, neighborhood safety does not impact sleep. Further research is warranted to identify mechanisms underlying the sex differences in susceptibility to poor sleep quality and shorter sleep duration, as well as to assess whether interventions addressing safety in the home can be used to improve sleep and overall health.
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Affiliation(s)
- Guido Simonelli
- Applied Neuroscience Laboratory, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina, and the National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Solange Rodríguez-Espínola
- Observatorio de la Deuda Social Argentina, Pontificia Universidad Católica Argentina, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Daniel Pérez-Chada
- Pulmonary Division, Department of Internal Medicine, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Agustín Salvia
- Observatorio de la Deuda Social Argentina, Pontificia Universidad Católica Argentina, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Daniel P Cardinali
- Applied Neuroscience Laboratory, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina, and the National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Daniel E Vigo
- Applied Neuroscience Laboratory, Institute for Biomedical Research (BIOMED), School of Medical Sciences, Pontifical Catholic University of Argentina, and the National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
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30
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Chambers E, Pichardo MS, Rosenbaum E. Sleep and the Housing and Neighborhood Environment of Urban Latino Adults Living in Low-Income Housing: The AHOME Study. Behav Sleep Med 2014; 14:169-84. [PMID: 25386692 PMCID: PMC4427540 DOI: 10.1080/15402002.2014.974180] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Sleep is implicated in the risk of many chronic diseases; however, little is known about the living conditions that influence sleep. In this study of 371 low-income Latino residents, household crowding was associated with reduced odds of long sleep duration relative to average and short sleep duration. Neighborhood disorder and perceived building problems were associated with more sleep disturbances and poor sleep quality. Building problems were associated with prolonged sleep latency. There was a significant cumulative effect of adverse housing and neighborhood conditions on sleep outcomes. These results show that adverse conditions of both the housing and neighborhood environments are associated with poor sleep outcomes.
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Affiliation(s)
- Earle Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine; 1300 Morris Park Avenue, Harold and Muriel Block Building 408; Bronx, NY10461, Phone: +1-718-430-3057
| | - Margaret S. Pichardo
- Program in Public Health, Stony Brook University (State University of New York); Health Sciences Center Level 3, Room 3-071; Stony Brook, NY US, Phone: +1-631-371-4582
| | - Emily Rosenbaum
- Department of Sociology and Anthropology; Fordham University, Dealy Hall 402C, 441 East Fordham Road; Bronx, NY 10458, Phone: 718-817-3858
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31
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Chen-Edinboro LP, Kaufmann CN, Augustinavicius JL, Mojtabai R, Parisi JM, Wennberg AMV, Smith MT, Spira AP. Neighborhood physical disorder, social cohesion, and insomnia: results from participants over age 50 in the Health and Retirement Study. Int Psychogeriatr 2014; 27:1-8. [PMID: 25222023 PMCID: PMC4362806 DOI: 10.1017/s1041610214001823] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
ABSTRACT Background: We determined the association between neighborhood socio-environmental factors and insomnia symptoms in a nationally representative sample of US adults aged >50 years. Methods: Data were analyzed from two waves (2006 and 2010) of the Health and Retirement Study using 7,231 community-dwelling participants (3,054 men and 4,177 women) in the United States. Primary predictors were neighborhood physical disorder (e.g. vandalism/graffiti, feeling safe alone after dark, and cleanliness) and social cohesion (e.g. friendliness of people, availability of help when needed, etc.); outcomes were insomnia symptoms (trouble falling asleep, night awakenings, waking too early, and feeling unrested). Results: After adjustment for age, income, race, education, sex, chronic diseases, body mass index, depressive symptoms, smoking, and alcohol consumption, each one-unit increase in neighborhood physical disorder was associated with a greater odds of trouble falling asleep (odds ratio (OR) = 1.09, 95% confidence interval (CI): 1.04-1.14), waking too early (OR = 1.05, 95% CI: 1.00-1.10), and, in adults aged ≥69 years (adjusting for all variables above except age), feeling unrested in the morning (OR = 1.11, 95% CI: 1.02-1.22 in 2006). Each one-unit increase in lower social cohesion was associated with a greater odds of trouble falling asleep (OR = 1.06, 95% CI: 1.01-1.11) and feeling unrested (OR = 1.09, 95% CI: 1.04-1.15). Conclusions: Neighborhood-level factors of physical disorder and social cohesion are associated with insomnia symptoms in middle-aged and older adults. Neighborhood-level factors may affect sleep, and consequently health, in our aging population.
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Affiliation(s)
- Lenis P Chen-Edinboro
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Christopher N Kaufmann
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Jura L Augustinavicius
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Ramin Mojtabai
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Jeanine M Parisi
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Alexandra M V Wennberg
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences,Johns Hopkins School of Medicine,Baltimore,Maryland,USA
| | - Adam P Spira
- Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,Maryland,USA
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32
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Chung S, Wilson KE, Miller AL, Johnson D, Lumeng JC, Chervin RD. Home Sleeping Conditions and Sleep Quality in Low-Income Preschool Children. SLEEP MEDICINE RESEARCH 2014. [DOI: 10.17241/smr.2014.5.1.29] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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