Neighborhood Disadvantage Is Associated with Lower Quality Sleep and More Variability in Sleep Duration among Urban Adolescents

Background: Research exploring the impact of the COVID-19 pandemic on sleep in people with disabilities has been scarce. This study provides a preliminary assessment of sleep in people with disabilities, across two timepoints during the pandemic, with a focus on those with visual impairment (VI).Methods: Two online surveys were conducted between April 2020 and March 2021 to explore sleep quality using the Pittsburgh Sleep Quality Index (PSQI). A convenience sample of 602 participants completed the first survey and 160 completed the follow-up survey.Results: Across both timepoints, participants with disabilities reported significantly poorer global sleep quality and higher levels of sleep disturbance, use of sleep medication and daytime dysfunction than those with no disabilities. Participants with VI reported significantly higher levels of sleep disturbance and use of sleep medication at both timepoints, poorer global sleep quality, sleep duration and latency at time 1, and daytime dysfunction at time 2, than those with no disabilities. Global sleep quality, sleep duration, sleep efficiency, and self-rated sleep quality deteriorated significantly in participants with no disabilities, but daytime dysfunction increased in all three groups. Disability and state anxiety were significant predictors of sleep quality across both surveys.Conclusion: While sleep was consistently poorer in people with disabilities such as VI, it appears that the COVID-19 pandemic has had a greater impact on sleep in people with no disabilities. State anxiety and, to a lesser extent, disability, were significant predictors of sleep across both surveys, suggesting the need to address anxiety in interventions targeted toward improving sleep.

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0360 Neighborhood Disadvantage is Associated with Lower Quality Sleep and More Variability in Weeknight Sleep Duration Among Urban Adolescents

SLEEP ◽

10.1093/sleep/zsaa056.357 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A137-A138

Author(s):

N G Nahmod ◽

L Master ◽

H F McClintock ◽

L Hale ◽

O M Buxton

Keyword(s):

Sleep Duration ◽

Summer School ◽

Multilevel Models ◽

Census Data ◽

National Level ◽

Neighborhood Disadvantage ◽

Disadvantaged Neighborhoods ◽

Falling Asleep ◽

Adolescent Sleep ◽

Race Ethnicity

Abstract Introduction Differential social and contextual environments may contribute to adolescent sleep disparities. Yet, most prior studies are limited to self-reported sleep data, and the actigraphic studies of sleep are not conducted at a national level, thus limiting the variation in neighborhood contexts. This study examined the association between neighborhood disadvantage and actigraphic assessment of adolescent sleep. Methods Participants (682 adolescents, mean age 15.4 years) were racially/ethnically diverse (44% Black, 26% Hispanic, 17% White, 14% other race/ethnicity), sampled from 20 large US cities in the Fragile Families and Child Wellbeing Study. Neighborhood disadvantage was calculated from American Community Survey 2015 census data using the Standardized Neighborhood Deprivation Index (SNDI), consolidating five variables (proportion of female-headed households, public assistance recipients, households in poverty, adults without high school degrees, and unemployed) into an index. SNDI quartiles 1-3 fell below national averages of SNDI variables (“most disadvantaged”) and were compared to quartile 4 (“least disadvantaged”). Sleep indicators (duration, quality, and timing) were measured over ≥5 nights using wrist-worn accelerometers. Separate multilevel models estimated differences in sleep indicators, adjusting for weekday/weekend and summer/school year. General linear models used within-person standard deviations of sleep indicators (controlling for number of days) to test for associations between neighborhood disadvantage and consistency of weeknight sleep patterns. Models adjusted for individual-level sociodemographic covariates (age, sex, race/ethnicity, household income, caregiver education, and family structure). Results In fully adjusted models, adolescents living in more disadvantaged neighborhoods spent more time awake after falling asleep (4.0 minutes/night, p<0.05), spent greater percentage of nighttime sleep intervals awake (1%, p<.01), and had less consistent sleep duration (11.7% higher standard deviation, p<.05). Sleep duration and timing did not differ across neighborhood groups. Conclusion Living in more disadvantaged neighborhoods is associated with lower quality adolescent sleep; more research is needed to identify causal mechanisms. Support Research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH), award numbers R01HD073352 (PI: Hale), R01HD36916, R01HD39135, and R01 HD40421, and private foundations. The content is the responsibility of the authors and does not represent official NIH views.

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Discrimination and adjustment in adolescence: the moderating role of sleep

SLEEP ◽

10.1093/sleep/zsab215 ◽

2021 ◽

Author(s):

Mona El-Sheikh ◽

Megan M Zeringue ◽

Ekjyot K Saini ◽

Thomas E Fuller-Rowell ◽

Tiffany Yip

Keyword(s):

Racial Discrimination ◽

Sleep Duration ◽

Externalizing Behavior ◽

Internalizing Symptoms ◽

Poor Quality ◽

Adjustment Problems ◽

Black African ◽

Quality Sleep ◽

Sleep Parameters ◽

Rule Breaking

Abstract Study Objectives We examined multiple actigraphy-based sleep parameters as moderators of associations between experiences of general and racial discrimination and adolescent internalizing symptoms (anxiety, depression) and externalizing behavior (rule-breaking). Adolescent sex and race were examined as additional moderators. Methods Participants were 272 adolescents (Mage = 17.3 years, SD = 0.76; 51% male; 59% White/European American, 41% Black/African American). Sleep was assessed using actigraphs for 7 consecutive nights from which sleep duration (minutes), efficiency, and variability in minutes over the week were derived. Youth reported on their experiences of general discrimination, racial discrimination, anxiety, depressive symptoms, and rule-breaking behavior. Results Both types of discrimination were associated with poorer adjustment outcomes. Longer sleep duration, greater sleep efficiency, and less variability in sleep duration were protective in associations between race-specific and general discrimination and internalizing symptoms. Findings for duration and efficiency were more pronounced for females such that the adverse effects of discrimination were minimized among females with longer and more efficient sleep. Greater variability in sleep exacerbated rule-breaking behavior among adolescents experiencing general or racial discrimination. Associations did not differ by adolescent race. Conclusions Short and poor-quality sleep may exacerbate internalizing symptoms for adolescents experiencing discrimination, particularly females. Variability in sleep duration was a key moderator of associations between discrimination and internalizing symptoms as well as rule-breaking behavior. Findings illustrate that actigraphy-assessed sleep parameters play a key role in ameliorating or exacerbating adjustment problems associated with discrimination.

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175 Household and Transnational Caregiving and Sleep in Latinx Adults: The modifying effects of employment status

SLEEP ◽

10.1093/sleep/zsab072.174 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A71-A71

Author(s):

Luciana Giorgio ◽

Carmela Alcantara

Keyword(s):

New York ◽

Sleep Quality ◽

Sleep Duration ◽

Employment Status ◽

Poor Sleep ◽

Moderating Effects ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Quality Sleep ◽

And Gender

Abstract Introduction Although caregiving is associated with shorter sleep durations and worse sleep quality, particularly among employed individuals, these studies have mostly examined household (i.e., child, adult) and domestic caregiving among majority non-Latinx White samples. Sending remittances, a form of transnational caregiving whereby financial support is provided to relatives in one’s country of origin, is associated with positive mental health among Latinxs, yet its association with sleep remains unexamined. We examined the association of household and transnational caregiving with sleep duration and quality, and explored the moderating effects of employment status on these relationships. Methods Using cross-sectional data of healthy Latinx adults in New York City (N=188), we conducted separate age and gender-adjusted linear regressions or logistic regressions to examine the association of caregiving and sleep duration, and poor sleep quality, respectively. Sleep duration (continuous) and sleep quality (fairly/very poor) were measured using two items from the PSQI. Household caregiving was defined as caregiving for children or adults in the household. Transnational caregiving was operationalized as sending remittances. Moderation was tested using employment status*caregiving cross-products in adjusted models. Results Participants were Mage=37.61(SD=14.07), 71.3% employed, 66.5% female, and 59.6% immigrants. Overall, 14.9% were household caregivers and 28.72% sent remittances. Household caregiving was not significantly associated with sleep duration or quality. Those who sent remittances reported on average sleeping 27.63 minutes less than non-remitters (b=-27.63,SE=13.93,p<0.05). Sending remittances was associated with 2.30 increased odds of reporting poor sleep quality (OR:2.30; 95%CI:1.03-5.14.) Employment status was a significant moderator (p<0.05). Among those who were employed, sending remittances was associated with 3 times higher odds of poor sleep quality (OR:3.00;95%CI:1.46-10.59) and 48.94 fewer minutes of sleep duration than non-remitters (b=-48.94,SE=15.72,p<0.05). These relationships were not observed among unemployed Latinxs. Conclusion Transnational caregivers were more likely to report shorter sleep duration and poorer sleep quality than their counterparts, and this was only observed among employed vs. unemployed Latinxs. Household caregiving was not significantly associated with sleep. Employed transnational caregivers may have multiple jobs that further constrain opportunities for longer and high-quality sleep. Future studies should examine potential upstream factors (e.g., working conditions) that may limit employed, transnational caregivers’ ability to obtain adequate sleep. Support (if any):

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Abstract P341: Poor Sleep Patterns Are Associated With Decreased Performance on the Montreal Cognitive Assessment in Both Younger and Older Women

Circulation ◽

10.1161/circ.137.suppl_1.p341 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Brooke Aggarwal ◽

Adam M Brickman ◽

Ming Liao ◽

Molly E Zimmerman

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Onset ◽

Poor Sleep ◽

Cvd Risk Factors ◽

Sleep Patterns ◽

Cvd Risk ◽

Quality Sleep

Introduction: Poor cardiovascular health has been linked to an increased likelihood of cognitive impairment in older adults. Cognitive impairment has also been identified as an emerging co-morbidity of obstructive sleep apnea, a highly prevalent sleep disorder, particularly in patients with neurological conditions. Whether other aspects of sleep, including sleep duration, sleep quality, sleep onset latency, and insomnia are associated with cognition is not established. Objective: The aim of this study was to evaluate whether specific sleep patterns were associated with cognitive function in a diverse population of both younger and older, neurologically healthy women, and to determine whether this association is mediated by cardiovascular disease (CVD) risk factors. Methods: This was a baseline analysis of 392 women (59% racial/ethnic minority, mean age=39±16.53y, range 20-76y) participating in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network population-based study at Columbia University Medical Center (CUMC). Cognitive function was assessed by the validated Montreal Cognitive Assessment (MoCA) screening instrument. Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index; insomnia was assessed using the Insomnia Severity Index. Blood lipids and glucose were measured in the biomarker core laboratory at CUMC. Multivariable linear regression models were used to evaluate associations between sleep, CVD risk factors, and MoCA scores, adjusted for age, race/ethnicity, education, health insurance, and tested for interactions between age and sleep. Results: The prevalence of abnormal MoCA (score <26) was 38%; mean scores were lower in adults ≥55y vs. <55y (p<0.0001), and racial/ethnic minorities vs. whites (p<0.0001). Average nightly sleep duration was 6.75±1.29 h, and 50% of women had poor sleep quality. In multivariable models testing for interactions, lower MoCA scores were associated with shorter sleep duration (p=0.007), worse quality sleep (p=0.0005), and higher insomnia level (p=0.04). In stratified analyses, associations between MoCA scores and sleep duration, sleep quality, and insomnia persisted among both younger (<55y) and older (≥55y) groups. Lower MoCA scores were also associated with higher triglycerides (p=0.0001) and lower HDL-cholesterol (p=0.0006); formal tests of mediation suggested that the relation between cognition and insomnia was mediated by triglyceride level. Conclusions: Poor sleep patterns were highly prevalent and associated with lower cognitive function, even in younger women in this diverse population. Sleep patterns should be further investigated as a potential mechanism to identify individuals at risk of cognitive decline. Whether the relation is causal or mediated through traditional CVD risk factors deserves further study.

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