Neighborhood Factors as Predictors of Poor Sleep in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos (original) (raw)
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Racial disparities in sleep: the role of neighborhood disadvantage
Sleep Medicine, 2016
Objective: Disparities in sleep duration and efficiency between Black/African American (AA) and White/ European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep. Methods: Data were from 133 AA and 293 EA adults who participated in the sleep assessment protocol of the Midlife in the United States (MIDUS) study (57% female; Mean Age ¼ 56.8 years, SD ¼ 11.4). Sleep minutes, onset latency, and waking after sleep onset (WASO) were assessed over seven nights using wrist actigraphy. Neighborhood characteristics were assessed by linking home addresses to tract-level socioeconomic data from the 2000 US Census. Multilevel models estimated associations between neighborhood disadvantage and sleep, and the degree to which neighborhood disadvantage mediated race differences in sleep controlling for family socioeconomic position and demographic variables. Results: AAs had shorter sleep duration, greater onset latency, and higher WASO than EAs (ps < 0.001). Neighborhood disadvantage was significantly associated with WASO (B ¼ 3.54, p ¼ 0.028), but not sleep minutes (B ¼-2.21, p ¼ 0.60) or latency (B ¼ 1.55, p ¼ 0.38). Furthermore, race was indirectly associated with WASO via neighborhood disadvantage (B ¼ 4.63, p ¼ 0.035), which explained 24% of the race difference. When measures of depression, health behaviors, and obesity were added to the model, the association between neighborhood disadvantage and WASO was attenuated by 11% but remained significant. Conclusion: Findings suggest that neighborhood disadvantage mediates a portion of race differences in WASO, an important indicator of sleep efficiency. Sleep is a fundamental biological process that plays a critical role in the maintenance of mental and physical health. Insufficient or low quality sleep has been consistently associated with adverse health outcomes including pre-disease markers of physiologic dysregulation such as inflammation [63], glucose metabolism [57], and hypothalamic-pituitary-adrenal axis functioning [83]. Sleep problems have also been linked with increased disease risk, including for cancer [89], diabetes [37], and heart disease [8], as well as life expectancy and mortality [24]. Furthermore, mounting evidence suggests that sleep is a consequential mediator of established associations between social/physical environment factors and health [90]. With respect to mental health and psychosocial functioning, insufficient sleep has been heavily associated with negative mood states [56], decreased ability to regulate thoughts and behaviors [80], and diminished productivity and learning [3]. All told, sleep problems are a significant impediment to health and well-being, which collectively, in the United States alone, carries an economic burden of hundreds of billions of dollars each year [32]. Recent meta-analyses and reviews of the literature reveal that Black/African American (AA) adults show consistently poorer sleep *
SLEEP, 2000
Neighborhoods and Sleep-DeSantis et al A number of studies have linked neighborhood characteristics to cardiovascular risk factors and outcomes, including body mass index (BMI), diabetes, hypertension, and cardiovascular events. 1-6 Important questions remain regarding whether these associations reflect causal processes, and if so, what the mediating mechanisms might be. In many studies, associations of neighborhood factors with cardiovascular-related outcomes persist after adjustment for standard risk factors, 2,4-7 suggesting that other mediators could be involved.
Sleep, 2015
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. Cross-sectional analysis. Community-based study. 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). N/A. 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 soc...
International Journal of Environmental Research and Public Health
Although low neighborhood social cohesion (nSC) has been linked with poor sleep, studies of racially/ethnically diverse participants using multiple sleep dimensions remain sparse. Using National Health Interview Survey data, we examined overall, age, sex/gender, and racial/ethnic-specific associations between nSC and sleep health among 167,153 adults. Self-reported nSC was categorized into low, medium, and high. Very short sleep duration was defined as <6 hours; short as <7 h, recommended as 7–9 h, and long as ≥9 h. Sleep disturbances were assessed based on trouble falling and staying asleep, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep dimensions by low and medium vs. high nSC. The mean age of the sample was 47 ± 0.1 years, 52% of those include...
Sleep
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. Higher levels of crime were associated with poorer sleep efficiency and longer WASO, but these associations were only evident in one of the neighborhoods. Several interactions emerged suggesting that the association between neighborhood characteristics and sleep outcomes differed by neighborhood. Conclusions: Both how residents perceive their neighborhood safety and their exposure to objectively measured crime have implications for sleep continuity. These findings suggest that neighborhood conditions may contribute to disparities in sleep health.
Sleep Health, 2016
Neighborhood characteristics have consistently been linked to physical and mental health outcomes and overall mortality (1, 2). Specifically, individuals living in neighborhood environments of lower socioeconomic status and/or with higher levels of adverse characteristics (e.g., neighborhood disorder, or lower levels of safety or social cohesion) have been found to have higher body mass index (BMI) (3, 4), diabetes (5), and hypertension (6, 7), among other risk factors. However, the specific mechanisms linking neighborhood characteristics to residents' health outcomes are not fully understood.
Sleep symptoms, race/ethnicity, and socioeconomic position
Journal of Clinical Sleep Medicine, 2013
Measurements and Results: Sociodemographics included age, sex, race/ethnicity, marital status, and immigration. Socioeconomics included poverty, education, private insurance, and food insecurity. Sleep symptoms assessed were sleep latency > 30 min, diffi culty falling asleep, sleep maintenance diffi culties, early morning awakenings, non-restorative sleep, daytime sleepiness, snorting/gasping, and snoring. Decreased reported problems for most symptoms were found among minorities, immigrants, and lower education levels. In general, in fully adjusted models, long sleep latency was associated with female gender, being black/African American, lower education attainment, no private insurance, and food insecurity. Diffi culty falling asleep, sleep maintenance diffi culties, early morning awakenings, and non-restorative sleep were also associated with female gender and food insecurity. Daytime sleepiness was seen in female and divorced respondents. Snorting/gasping was more prevalent among male, other-Hispanic/Latino, and 9 th -to 11 th -grade-level respondents. Snoring was prevalent among male, other-Hispanic/Latino, less-educated, and foodinsecure respondents. Conclusions: Sleep symptoms were associated with multiple sociodemographic and economic factors, though these relationships differed by predictor and sleep outcome. Also, reports depended on question wording. keywords: Insomnia, sleep disorders, race/ethnicity, socioeconomic status, health disparities Citation: Grandner MA; Petrov MER; Rattanaumpawan P; Jackson N; Platt A; Patel NP. Sleep symptoms, race/ethnicity, and socioeconomic position. J Clin Sleep Med 2013;9(9):897-905.
Sleep, 2019
Study Objectives: We examined the association of sociocultural stress severity (i.e. acculturation stress, ethnic discrimination) and chronic stress burden with multiple dimensions of sleep in a population-based sample of US Hispanics/Latinos. We also explored whether employment status modified stress-sleep associations. Methods: We conducted survey linear regressions to test the cross-sectional association of sociocultural stress severity and stress burden with sleep dimensions using data collected between 2010 and 2013 from individuals who participated in both the Hispanic Community Health Study/Study of Latinos Sueño and Sociocultural Ancillary studies (N = 1192). Results: Greater acculturation stress (B = 0.75, standard error [SE] = 0.26, p < .01) and chronic psychosocial stress burden (B = 1.04, SE = 0.18, p < .001) were associated with greater insomnia symptoms but were not associated with actigraphic measures of sleep. Ethnic discrimination was not associated with any of the sleep dimensions. The association of acculturation stress with insomnia severity was greater in unemployed (B = 2.06, SE = 0.34) compared to employed (B = 1.01, SE = 0.31) participants (p-interaction = .08). Conclusions: Acculturation stress severity and chronic stress burden are important and consistent correlates of insomnia, but not actigraphically measured sleep dimensions. If replicated, future research should test whether interventions targeting the resolution of sociocultural stress improve sleep quality in Hispanics/Latinos.
Perceived Neighborhood Safety and Sleep Quality: A Global Analysis of Six Countries
Objective: Building on previous North American and European studies of neighborhood context and sleep quality, we tested whether several self-reported sleep outcomes (sleep duration, insomnia symptoms, sleepiness, lethargy, and overall sleep quality) vary according to level of perceived neighborhood safety in six countries: Mexico, Ghana, South Africa, India, China, and Russia. Methods: Using data from Wave I of the World Health Organization’s Longitudinal Study on Global AGEing and Adult Health (2007-2010), we estimate a series of multinomial and binary logistic regression equations to model each sleep outcome within each country. Results: Taken together, our results show that respondents who feel safe from crime and violence in their neighborhoods tend to exhibit more favorable sleep outcomes than respondents who feel less safe. This general pattern is especially pronounced in China and Russia, moderately evident in Mexico, Ghana, and South Africa, and sporadic in India. Perceptions of neighborhood safety are strongly associated with insomnia symptoms and poor sleep quality (past 30 days), moderately associated with sleepiness, lethargy, and poor sleep quality (past 2 days), and inconsistently associated with sleep duration (past 2 days). Conclusions: Additional research is needed to replicate our findings using longitudinal data, more reliable neighborhood measures, and more direct measures of sleep quality. Future work should continue to investigate contextual variations in sleep patterns in understudied regions of the world, including Central America, the Caribbean, South America, Europe, West Asia/the Middle East, and Southeast Asia.