Neighborhood Social Cohesion and Sleep Health by Age, Sex/Gender, and Race/Ethnicity in the United States

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 included were women, and 69% were Non-Hispanic (NH)-White. Low vs. high nSC was associated with a higher prevalence of very short sleep (PR = 1.29; (95% CI = 1.23–1.36)). After adjustment, low vs. high nSC was associated with very short sleep duration among NH-White (PR = 1.34 (95% CI = 1.26–1.43)) and NH-Black (PR = 1.14 (95% CI = 1.02–1.28)) adults. Low nSC was associated with shorter sleep duration and sleep disturbances.

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534 Food Insecurity and Sleep Health by Race/Ethnicity and Age Group in the United States

SLEEP ◽

10.1093/sleep/zsab072.532 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A211-A211

Author(s):

Nyree Riley ◽

Dana Alhasan ◽

W Braxton Jackson ◽

Chandra Jackson

Keyword(s):

Food Security ◽

Food Insecurity ◽

Sleep Duration ◽

Sleep Disturbances ◽

The United States ◽

Poor Sleep ◽

High Food ◽

Short Sleep Duration ◽

Sleep Health ◽

Falling Asleep

Abstract Introduction Food insecurity may influence sleep through poor mental health (e.g., depression) and immune system suppression. Although prior studies have found food insecurity to be associated with poor sleep, few studies have investigated the food security-sleep association among racially/ethnically diverse participants and with multiple sleep dimensions. Methods Using National Health Interview Survey data, we examined overall, age-, sex/gender-, and racial/ethnic-specific associations between food insecurity and sleep health. Food security was categorized as very low, low, marginal, and high. Sleep duration was categorized as very short (<6 hours), short (<7 hours), recommended (7–9 hours), and long (≥9 hours). Sleep disturbances included trouble falling and staying asleep, insomnia symptoms, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (95% CI) for sleep dimensions by very low, low, and marginal vs. high food security. Results The 177,435 participants’ mean age was 47.2±0.1 years, 52.0% were women, 68.4% were Non-Hispanic (NH)-White. Among individuals reporting very low food security, 75.4% had an annual income of <$35,000 and 60.3% were ≥50 years old. After adjustment, very low vs. high food security was associated with a higher prevalence of very short (PR=2.61 [95%CI: 2.44–2.80]) and short (PR=1.66 [95% CI: 1.60–1.72]) sleep duration. Very low vs. high food security was associated with both trouble falling asleep (PR=2.21 [95% CI: 2.12–2.30]) and trouble staying asleep (PR=1.98 [95% CI: 1.91–2.06]). Very low vs. high food security was associated with higher prevalence of very short sleep duration among Asians (PR=3.64 [95% CI: 2.67–4.97]), Whites (PR=2.73 [95% CI: 2.50–2.99]), Blacks (PR=2.03 [95% CI: 1.80–2.31]), and Hispanic/Latinxs (PR=2.65 [95% CI: 2.30–3.07]). Conclusion Food insecurity was associated with poor sleep in a diverse sample of the US population. Support (if any):

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Anxiety and depressive symptoms are associated with poor sleep health during a period of COVID-19-induced nationwide lockdown: a cross-sectional analysis of adults in Jordan

BMJ Open ◽

10.1136/bmjopen-2020-041995 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041995

Author(s):

Yazan A Al-Ajlouni ◽

Su Hyun Park ◽

Jude Alawa ◽

Ghaith Shamaileh ◽

Aziz Bawab ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Health Outcomes ◽

Sleep Duration ◽

Sleep Problem ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Sleep Health ◽

Short Sleep

Background Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. Methods Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. Results The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose–response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). Conclusions Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.

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Bidirectional Associations Between Activity Diversity and Sleep

Innovation in Aging ◽

10.1093/geroni/igaa057.2248 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 652-652

Author(s):

Soomi Lee ◽

Susan Charles ◽

David Almeida

Keyword(s):

Sleep Duration ◽

Well Being ◽

Total Activity ◽

The United States ◽

Poor Sleep ◽

Short Sleep Duration ◽

Sleep Health ◽

Activity Data ◽

Bidirectional Relationship ◽

Bidirectional Associations

Abstract Activity diversity is important for psychological well-being and cognitive functioning. Yet, little is known about the relationship between activity diversity and sleep. This study examined how overall and nightly sleep health are associated with activity diversity. Participants (N=1841) from the Midlife in the United States Study II provided activity data for 8 days. We constructed overall and daily activity diversity scores. A composite score of overall sleep health across 8 dimensions and nightly sleep duration were measured. Analyses adjusted for sociodemographics, total activity time, and positive/negative affect. Participants with poorer sleep health overall had a lower activity diversity. On days following nights with short (<6hrs) or long (>8hrs) sleep duration, participants engaged in fewer-than-usual activities. Conversely, fewer daily activities also predicted long (but not short) sleep duration. Our results suggest cyclical associations between poor sleep health and activity diversity day-to-day, which, may accumulate over time to form a bidirectional relationship.

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Short sleep duration and poor sleep quality among migraineurs: A population-based study

Cephalalgia ◽

10.1177/0333102417716936 ◽

2017 ◽

Vol 38 (5) ◽

pp. 855-864 ◽

Cited By ~ 15

Author(s):

Tae-Jin Song ◽

Chang-Ho Yun ◽

Soo-Jin Cho ◽

Won-Joo Kim ◽

Kwang Ik Yang ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Sleep Disturbances ◽

Population Based ◽

Poor Sleep ◽

Headache Frequency ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Short Sleep ◽

The Impact

Background Sleep disturbances are closely related to migraine. Nevertheless, information regarding the impact of short sleep duration and poor sleep quality on the clinical presentation of migraine at population level is limited. Methods This study was a nationwide population-based survey on adults aged 19–69 years. Headache frequency (attacks/month) and intensity (visual analogue scale, 0–10) were documented. Short sleep duration and poor sleep quality were defined as average sleep duration <6 h/day and Pittsburgh Sleep Quality Index score >5, respectively. The association of sleep parameters with headache frequency and intensity was analysed among migraineurs. Results Of 2695 participants, 143 (5.3%) had migraine. Headache frequency was significantly higher among migraineurs with short sleep duration (2.0 [1.0–12.0] vs. 1.0 [0.3–4.0], p = 0.048) and poor sleep quality (2.0 [0.6–4.7] vs. 1.0 [0.2–3.0], p = 0.009) than among those without. However, headache intensity was similar between migraineurs with short sleep duration and poor sleep quality. Multiple linear regression analyses revealed that short sleep duration was a significant contributing factor for headache frequency (β = 0.210, p = 0.015). Conclusions Self-reported short sleep duration (<6 h per day) is associated with an increased headache frequency among migraineurs in a population-based setting.

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170 Hispanic Ethnicity May Be Associated with Short Sleep Duration and Elevated Sleep Distress in U.S. Air Force Trainees

SLEEP ◽

10.1093/sleep/zsab072.169 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A69-A69

Author(s):

Rosemary Estevez Burns ◽

Xin Qun Wang ◽

Marc Patience ◽

Jordan Ellis ◽

Wayne Talcott ◽

...

Keyword(s):

Sleep Duration ◽

Air Force ◽

Technical Training ◽

Sleep Pattern ◽

Poor Sleep ◽

Short Sleep Duration ◽

Sleep Health ◽

Short Sleep ◽

Race Ethnicity ◽

Processing Group

Abstract Introduction Sleep research among Hispanic populations is limited. Hispanics may be at higher risk of poor sleep when compared to other race/ethnicities. Non-white and other socioeconomically disadvantaged populations have higher rates of chronic health conditions. Epidemiological studies have substantiated the correlation between short sleep and a variety of negative health outcomes. Sleep is foundational to overall good health and functioning, impacting academic and physical performance in technical training, and crucial for an airmen’s adjustment to the rigor of a military career. Authors explored the role of race/ethnicity on perceived sleep health (e.g., sleep duration and sleep distress) among airmen attending technical school. Methods Sleep health survey was administered to two groups of Airmen at an Air Force technical training: In-processing: Airmen who just arrived to begin technical training, (n=187), Age: M= 20.83 (SD 3.26), 82.55% Male; upon completion of training, i.e., Out-processing: Airmen about to complete technical training, (n=302), Age M = 20.7 (SD 3.09), 85.81% Male. To account for correlations between Airmen from the same squadron, a covariates-adjusted generalized mixed-effects model was used. Associations between race/ethnicity and short sleep duration (≤6 hours), and between race/ethnicity and sleep pattern distress—among shorter sleepers as a sub-group—were examined. Racial/Ethnic frequency among short sleepers (n=135): 19.3 % Hispanic, 13.3% NH-Black, 55.6% NH-White, 6.6% NH-Multiracial, and 5.2% NH-Other. Results Among Hispanic Airmen, the out-processing group was 2.25 times as likely as the in-processing group to be short sleepers on weekdays (95% CI: 1.15 to 4.38, p=0.017). Among short sleepers in the out-processing group, Hispanic Airmen were significantly more worried/distressed about their sleep pattern than Black and White Airmen (OR=2.29, 95% CI: 1.18 to 4.42, p=0.014 and OR=2.29, 95% CI: 1.10 to 4.76, p=0.026, respectively). Conclusion Short sleep duration is a significant problem in the military and results suggest that race/ethnicity-related contextual factors may point to at risk subgroups. Others have considered the influence of perceived prejudice, access to social capital, cultural barriers to academic success, and potential sensitivity to somatic discomfort on sleep complaints. Future directions involve repeating this assessment with another cohort of technical training Airmen to see if findings replicate. Support (if any) none

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Abstract P336: The Association Between Goal-Striving Stress, Sleep Duration and Sleep Quality in the Jackson Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.p336 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Loretta Cain ◽

LáShauntá Glover ◽

Dayna Johnson ◽

Mario Sims

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Poor Sleep ◽

Jackson Heart Study ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Logistic Regression Models ◽

Short Sleep ◽

Goal Striving ◽

Heart Study

Introduction: Research shows that compared to non-Hispanic whites, African Americans (AAs) have poorer sleep quality, lower mean sleep duration, and a higher prevalence of sleep-disordered breathing. AAs also report more frequent exposures to certain stressors over the life course, which may impact physiological processes that may impair sleep. Goal-striving-stress (GSS), the discrepancy between aspiration and achievement, weighted by the subjective probability of success, and the level of disappointment experienced if goals are not reached, may be an important stressor among AA’s that may influence sleep; however this has yet to be explored. The objective of this study was to assess the relationship between GSS and sleep duration and sleep quality in AAs. Hypothesis: We assessed the hypothesis that high (versus low) GSS would be associated with short or long sleep duration and poor sleep quality. Methods: We utilized data from the baseline exam of the Jackson Heart Study (JHS; n=5306), an AA sample of women and men, 35-84 years old. There were a total of 5082 participants in the sample; 63.34% female with a mean age of 55.30 (± 12.75) and mean sleep duration of 6.43 hours (±1.51). The sample was categorized into GSS tertiles: low (n=2121), moderate (n=1716), high (n=1296). Participants self-reported sleep duration (hours) and rated their sleep quality. Sleep duration was categorized as short ( < 6 hours), normal (7 or 8 hours) and long ( > 9 hours). Sleep quality was categorized as high (good/very good/excellent) and low (fair/poor). Logistic regression models were used to obtain odds ratios (OR, 95% confidence interval-CI) to assess the associations of GSS levels with sleep duration and sleep quality categories. Models were adjusted for sex, age, socioeconomic status, health behaviors, discrimination, and health outcomes. Results: Significant results showed that participants who reported high (versus low) GSS had a 29% increased odds [1.29 (1.10, 1.52)] of short (versus normal) sleep after full adjustment. Participants who reported high (versus low) GSS had a 42% increased odds [1.42 (1.20, 1.67)] of low (versus high) sleep quality after full adjustment. Conclusion In conclusion, the deficit between goal aspiration and achievement is associated with short sleep duration and poor sleep quality. Potential interventions should consider the extent to which GSS may contribute to the development of short sleep duration and poor sleep quality.

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0927 Variations in Sleep and Glucose in Adolescents with Type 1 Diabetes

SLEEP ◽

10.1093/sleep/zsaa056.923 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A352-A353

Author(s):

S Griggs ◽

N S Redeker ◽

S Jeon ◽

M Grey

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Sleep Duration ◽

Sleep Onset ◽

Glucose Variability ◽

Poor Sleep ◽

Short Sleep Duration ◽

High Blood Glucose ◽

Short Sleep

Abstract Introduction The association between short sleep duration and poorer glycemic control in adolescents ages 10-16 with type 1 diabetes (T1D) is well established. Researchers have used cross-sectional, between-subjects’ methods, with limited focus on the potential intraindividual variation among these variables. The purpose of this analysis was to examine the within person associations between glucose variability indices (J index, low/high blood glucose index, time in range) and sleep characteristics (bedtime, waketime, total sleep time, sleep efficiency, wake after sleep onset [WASO], awakenings, and sleep fragmentation index) in adolescents with T1D. Methods Adolescents monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and either their own continuous glucose monitor (CGM) or a provided blinded CGM. General linear mixed models (GLMM) were used to determine within-person and day level associations. Results The sample included 38 adolescents (M age 13.4±1.8; 37.8% male; M A1C 8.2±1.2%). Average glucose levels were controlled in all GLMMs. Adolescents had earlier waketimes on days when more time was spent in hypoglycemia <70mg/dL (β=-0.15, p<0.001). At the person level, adolescents had greater WASO with more % time spent in severe hypoglycemia <54mg/dL with more severe low blood glucose indices (β=0.35, p<0.01 and β=0.34, p<0.01 respectively). At the daily level, adolescents had greater WASO (β=0.20, p=0.01) and more awakenings (β=0.16, p=0.04) on the days they had more overall glucose variability (J index) and more severe high blood glucose indices (β=0.17, p=0.04), but were less likely to have more % time in hypoglycemia (β=-0.15, p=0.02). Conclusion Glucose variability was positively associated with poor sleep (e.g., WASO and awakenings) in adolescents with T1D both at the daily and intraindividual level. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person associations between habitual short sleep duration and glucose variability. Support NINR T32NR0008346 & P20NR014126, Medtronic MiniMed provided CGMs at a discounted rate for the study.

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Associations of allostatic load with sleep apnea, insomnia, short sleep duration, and other sleep disturbances: findings from the National Health and Nutrition Examination Survey 2005 to 2008

Annals of Epidemiology ◽

10.1016/j.annepidem.2014.05.014 ◽

2014 ◽

Vol 24 (8) ◽

pp. 612-619 ◽

Cited By ~ 46

Author(s):

Xiaoli Chen ◽

Susan Redline ◽

Alexandra E. Shields ◽

David R. Williams ◽

Michelle A. Williams

Keyword(s):

Sleep Apnea ◽

Sleep Duration ◽

National Health ◽

Allostatic Load ◽

Sleep Disturbances ◽

Nutrition Examination Survey ◽

Short Sleep Duration ◽

Short Sleep ◽

Health And Nutrition

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879Sleep Duration and all-cause and cause-specific mortality in people with diabetes

International Journal of Epidemiology ◽

10.1093/ije/dyab168.430 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Yohannes Adama Melaku ◽

Sarah Appleton ◽

Amy Reynolds ◽

Tiffany Gills ◽

Robert Adams

Keyword(s):

Sensitivity Analysis ◽

Sleep Duration ◽

Dose Response ◽

Mortality Risk ◽

The United States ◽

Diabetic Patients ◽

Short Sleep Duration ◽

Short Sleep ◽

Long Sleep ◽

Specific Mortality

Abstract Background Evidence shows that habitual short and long sleep is associated with higher mortality risk in the general population. However, studies on the association between sleep duration and mortality in people with diabetes are scarce. Methods Data from the National Health Interview Survey (NHIS) of the United States (US) between 2004 and 2014 (N = 32,766) were used. Self-reported habitual sleep duration for those with self-reported doctor diagnosed diabetes was categorized as ≤ 6 hr (short sleep), 7-8 hr (adequate sleep), and ≥9 hr (long sleep). Mortality status and cause of death data were retrieved from the US National Death Index and linked. We used adjusted Cox proportional models to examine the association between sleep duration and mortality risk. Dose-response relationships were quantified. Sensitivity analysis was performed excluding cardiovascular and cancer cases. Results In the median follow-up time of 4.6 years (171,375.2 person-years), 5312 all-cause, 1129 cardiovascular, 1148 cancer and 494 diabetes deaths were recorded. Whereas short sleep duration (adjusted hazard ratio (aHR)=1.04; 95% confidence interval (CI): 0.97, 1.11) in diabetic patients was not associated with all-cause mortality, long sleep duration was positively (aHR=1.43; 95% CI: 1.30, 1.57) associated with increased mortality risk. A similar trend of association was found with cause-specific mortality and the dose-response analysis identified a “J” shape association. Similar results were found upon sensitivity analysis. Conclusions Long but not short sleep duration is associated with all-cause and cause-specific mortality in diabetic patients. Key messages Sleep should be part of behavioural intervention to prevent premature mortality in those with diabetics.

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Sleep Duration and Excessive Daytime Sleepiness Are Associated with Obesity Independent of Diet and Physical Activity

Nutrients ◽

10.3390/nu10091219 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1219 ◽

Cited By ~ 23

Author(s):

Andrea Maugeri ◽

Jose Medina-Inojosa ◽

Sarka Kunzova ◽

Antonella Agodi ◽

Martina Barchitta ◽

...

Keyword(s):

Physical Activity ◽

Sleep Duration ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Central Obesity ◽

Sleep Disturbances ◽

Short Sleep Duration ◽

Cross Sectional ◽

Short Sleep ◽

Diet And Physical Activity

In the European Union, Czech Republic ranks 3rd and 6th for the incidence of obesity and cardiovascular diseases, respectively. Worldwide, short sleep duration and excessive daytime sleepiness (EDS) characterize obese subjects, which in turn exhibit scarce physical activity and unhealthy diet. We aimed to understand the relationship between irregular sleep patterns, obesity and lifestyle factors, such as diet and physical activity, in a vulnerable Czech population. 1482 members of the Kardiovize cohort, a random sample of the Czech urban population, were included in a cross-sectional study. Exposure variables included self-reported sleep duration and EDS, assessed by the Epworth Sleepiness Scale. Primary outcomes were BMI and waist-to-hip ratio or prevalence of obesity and central obesity. Covariates included physical activity and diet. Associations and interactions between variables were evaluated using logistic regression analyses. After adjustment for covariates, short sleep duration (<7 h) was associated with greater odds of overweight (BMI > 25; OR = 1.42; 95%CI = 1.06–1.90; p = 0.020) and obesity (BMI > 30; OR = 1.40; 95%CI = 1.02–1.94; p = 0.047), while EDS was associated with greater odds of central obesity (OR = 1.72; 95%CI = 1.06–2.79; p = 0.030), independent of diet and physical activity. However, due to the cross-sectional nature of our study, further prospective, large-scale studies are needed to evaluate the etiological link and causality between sleep disturbances and obesity.

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