1
|
Al-Khalil Z, Attarian H, Dunietz GL, Gavidia Romero R, Knutson K, Johnson DA. Sleep health inequities in vulnerable populations: Beyond sleep deserts. Sleep Med X 2024; 7:100110. [PMID: 38623559 PMCID: PMC11017343 DOI: 10.1016/j.sleepx.2024.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/21/2024] [Accepted: 03/29/2024] [Indexed: 04/17/2024] Open
Abstract
Despite the importance of sleep to overall health and well-being, there is a high prevalence of undiagnosed sleep disorders and adverse sleep health, particularly among vulnerable populations. Such vulnerable populations include people experiencing homelessness (PEH), refugees, and incarcerated individuals. In this narrative review, we provide an overview of the literature on sleep health and disorders among key and vulnerable populations (e.g., PEH, refugees, and incarcerated individuals). The limited research among these populations indicated a high prevalence of sleep disorders, mainly insomnia, short sleep duration, and fatigue. Substance abuse and PTSD were commonly found among PEH and refugee populations, respectively, which were was related to poor sleep. Similar across the included vulnerable populations, the individuals reside in environments/facilities with inopportune light exposure, noise disruption, inadequate bedding, and forced sleep schedules. Studies also found a high prevalence of psychosocial stress and reports of threats to safety, which were associated with poor sleep health outcomes. Additionally, several studies reported environmental barriers to adherence to sleep disorder treatment. This paper highlighted the conditions in which these vulnerable populations reside, which may inform interventions within these various facilities (homeless shelters, refugee camps, prisons/jails). The improvement of these facilities with a sleep equity focus may in turn improve quality of life and daily functioning.
Collapse
Affiliation(s)
| | - Hrayr Attarian
- Department of Neurology, Northwestern University Feinberg School of Medicine, USA
| | - Galit Levi Dunietz
- Department of Neurology, School of Medicine, University of Michigan, USA
| | | | - Kristen Knutson
- Department of Neurology, Northwestern University Feinberg School of Medicine, USA
| | - Dayna A. Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| |
Collapse
|
2
|
Johnson SL, Murray G, Kriegsfeld LJ, Manoogian ENC, Mason L, Allen JD, Berk M, Panda S, Rajgopal NA, Gibson JC, Joyner KJ, Villanueva R, Michalak EE. A randomized controlled trial to compare the effects of time-restricted eating versus Mediterranean diet on symptoms and quality of life in bipolar disorder. BMC Psychiatry 2024; 24:374. [PMID: 38762486 PMCID: PMC11102174 DOI: 10.1186/s12888-024-05790-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/25/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND The primary objective of this randomized controlled trial (RCT) is to establish the effectiveness of time-restricted eating (TRE) compared with the Mediterranean diet for people with bipolar disorder (BD) who have symptoms of sleep disorders or circadian rhythm sleep-wake disruption. This work builds on the growing evidence that TRE has benefits for improving circadian rhythms. TRE and Mediterranean diet guidance will be offered remotely using self-help materials and an app, with coaching support. METHODS This study is an international RCT to compare the effectiveness of TRE and the Mediterranean diet. Three hundred participants will be recruited primarily via social media. Main inclusion criteria are: receiving treatment for a diagnosis of BD I or II (confirmed via DIAMOND structured diagnostic interview), endorsement of sleep or circadian problems, self-reported eating window of ≥ 12 h, and no current mood episode, acute suicidality, eating disorder, psychosis, alcohol or substance use disorder, or other health conditions that would interfere with or limit the safety of following the dietary guidance. Participants will be asked to complete baseline daily food logging for two weeks and then will be randomly allocated to follow TRE or the Mediterranean diet for 8 weeks, during which time, they will continue to complete daily food logging. Intervention content will be delivered via an app. Symptom severity interviews will be conducted at baseline; mid-intervention (4 weeks after the intervention begins); end of intervention; and at 6, 9, and 15 months post-baseline by phone or videoconference. Self-rated symptom severity and quality of life data will be gathered at those timepoints, as well as at 16 weeks post baseline. To provide a more refined index of whether TRE successfully decreases emotional lability and improves sleep, participants will be asked to complete a sleep diary (core CSD) each morning and complete six mood assessments per day for eight days at baseline and again at mid-intervention. DISCUSSION The planned research will provide novel and important information on whether TRE is more beneficial than the Mediterranean diet for reducing mood symptoms and improving quality of life in individuals with BD who also experience sleep or circadian problems. TRIAL REGISTRATION ClinicalTrials.gov ID NCT06188754.
Collapse
Affiliation(s)
- Sheri L Johnson
- Department of Psychology, University of California, Berkeley, USA.
| | - Greg Murray
- Centre for Mental Health, Swinburne University, Melbourne, VIC, 3122, Australia
| | | | - Emily N C Manoogian
- Regulatory Biology, Salk Institute for Biological Studies, La Jolla, CA, 92037, USA
| | - Liam Mason
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - J D Allen
- Department of Psychology, University of California, Berkeley, USA
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Satchidanda Panda
- Regulatory Biology, Salk Institute for Biological Studies, La Jolla, CA, 92037, USA
| | | | - Jake C Gibson
- Department of Psychology, University of California, Berkeley, USA
| | - Keanan J Joyner
- Department of Psychology, University of California, Berkeley, USA
| | | | - Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
3
|
Gaston SA, Alhasan DM, Johnson DA, Hale L, Harmon QE, Baird DD, Jackson CL. Perceived childhood neighborhood safety and sleep health during childhood and adulthood among a cohort of African American women. Sleep Med 2024; 117:115-122. [PMID: 38531166 DOI: 10.1016/j.sleep.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To investigate associations between perceived childhood neighborhood safety and sleep over the life course. METHODS Among a cohort of 1693 Black/African American women aged 23-35 years at enrollment (2010-2012), participants recalled neighborhood safety (safe vs. unsafe) when they were 5, 10, and 15 years old. Participants' mothers/caregivers and participants reported sleep-related health behaviors at age 5. We used ordinal logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep-related health behaviors (i.e., rarely/never or sometimes vs. mostly/always going to bed by 8:00 p.m., bed in a quiet room, bed in a dimly lit or unlit room), separately. Adulthood sleep duration and insomnia symptoms were reported at enrollment and over three follow-up periods. We applied generalized estimating equations to log binomial regression models to estimate relative risks (RR) for adulthood sleep characteristics. RESULTS AND CONCLUSIONS Four percent of participants reported an unsafe neighborhood at age 5 years, only, and 12% reported an unsafe neighborhood at all ages. Participants in perceived unsafe vs. safe neighborhoods at age 5 had higher odds of poor sleep-related health behaviors (e.g., rarely/never or sometimes going to bed in a quiet room: OR = 1.73 [1.27-2.35]). Participants in perceived unsafe vs. safe neighborhoods throughout childhood had higher risk of short sleep (RR = 1.10 [1.02-1.18]) and insomnia symptoms (RR = 1.07 [1.00-1.15]) during adulthood after adjustment for life course socioeconomic characteristics and adulthood health behaviors and characteristics. Perceived unsafe childhood neighborhood was associated with poorer sleep over the life course and may serve as an early intervention target.
Collapse
Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY, USA
| | - Quaker E Harmon
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| |
Collapse
|
4
|
Johnson DA, Wallace DA, Ward L. Racial/ethnic and sex differences in the association between light at night and actigraphy-measured sleep duration in adults: NHANES 2011-2014. Sleep Health 2024; 10:S184-S190. [PMID: 37951773 PMCID: PMC11031299 DOI: 10.1016/j.sleh.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Historically minoritized individuals experience greater exposure to light at night, yet it is unclear whether the association between light at night and sleep duration vary by race/ethnicity or sex. We examined the association between light at night and sleep duration by race/ethnicity and sex. METHODS Participants (N = 6089, mean age=49.5, 52% women, 13% Asian, 27% Black, 14% Mexican, 46% White) in the 2011-2014 National Health and Nutrition Examination Survey underwent 9-day of actigraphy. Light at night was defined as light exposure within the 5-hour activity nadir (L5). Sleep duration within a 24-hour period was analyzed as short (<7 hours) or long (>9 hours) compared to recommended (≥7 and <9 hours). Poisson models were fit to estimate the association between light at night and sleep duration after adjustment for covariates. RESULTS Light at night was most common among Black participants, who also had the shortest sleep duration. Overall, light at night was associated with 80% higher prevalence of short sleep duration [1.80 (1.49, 2.18)]. Compared to no-light at night, low and high light at night were associated with higher prevalence of short sleep duration, [1.61 (1.31, 1.98) and 2.01 (1.66, 2.44), respectively]. Associations varied by race/ethnicity and sex. Light at night was associated with shorter sleep duration in Black, Mexican and White females and Mexican and White males only. Black males exposed to light at night vs. no-light at night had lower prevalence of long sleep duration. There were no associations between light at night and sleep duration among Asian participants. CONCLUSION Light at night was associated with shorter sleep duration, particularly among females. Targeting light exposure may help to improve sleep duration.
Collapse
Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
| | - Danielle A Wallace
- Department of Medicine, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Laura Ward
- Department of Biostatistics and Informatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
5
|
Garcia CM, Schrier EF, Carey C, Valle KA, Evans JL, Kushel M. Sleep Quality among Homeless-Experienced Older Adults: Exploratory Results from the HOPE HOME Study. J Gen Intern Med 2024; 39:460-469. [PMID: 37783981 PMCID: PMC10897106 DOI: 10.1007/s11606-023-08429-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults. OBJECTIVE To examine the factors associated with poor sleep quality in a cohort of older adults in Oakland, California recruited while homeless using venue-based sampling and followed regardless of housing status. DESIGN Longitudinal cohort study. PARTICIPANTS 244 homeless-experienced adults aged ≥ 50 from the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) cohort. MAIN MEASURES We assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). We captured variables via biannual questionnaires and clinical assessments. KEY RESULTS Our sample was predominantly men (71.3%), Black (82.8%), and had a median age of 58.0 years old (IQR 54.0, 61.0). Two-thirds of participants (67.2%) reported poor sleep during one or more study visits; sleep duration was the worst rated subdomain. In a multivariable model, having moderate-to-severe depressive symptoms (AOR 2.03, 95% CI 1.40-2.95), trouble remembering (AOR 1.56, 95% CI 1.11-2.19), fair or poor physical health (AOR 1.49, 95% CI 1.07-2.08), two or more chronic health conditions (AOR 1.76, 95% CI 1.18-2.62), any ADL impairment (AOR 1.85, 95% CI 1.36-2.52), and being lonely (AOR 1.55, 95% CI 1.13-2.12) were associated with increased odds of poor sleep quality. Having at least one confidant was associated with decreased odds of poor sleep (AOR 0.56, 95% CI 0.37-0.85). Current housing status was not significantly associated with poor sleep quality. CONCLUSIONS Homeless-experienced older adults have a high prevalence of poor sleep. We found that participants' physical and mental health was related to poor sleep quality. Poor sleep continued when participants re-entered housing. Access to physical and mental healthcare, caregiving support, and programs that promote community may improve homeless-experienced older adults sleep quality, and therefore, their overall health.
Collapse
Affiliation(s)
- Cheyenne M Garcia
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Elizabeth F Schrier
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Caitlin Carey
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Karen A Valle
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer L Evans
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Margot Kushel
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA.
- UCSF Benioff Homelessness and Housing Initiative, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
6
|
Ravindran KKG, della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, Dijk DJ. Contactless and longitudinal monitoring of nocturnal sleep and daytime naps in older men and women: a digital health technology evaluation study. Sleep 2023; 46:zsad194. [PMID: 37471049 PMCID: PMC10566241 DOI: 10.1093/sleep/zsad194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/16/2023] [Indexed: 07/21/2023] Open
Abstract
STUDY OBJECTIVES To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults. METHODS We collected 7-14 days of data at home from 35 older adults (age: 65-83), some with medical conditions, using Withings Sleep Analyser (WSA, n = 29), Emfit QS (Emfit, n = 17), a standard actigraphy device (Actiwatch Spectrum [AWS, n = 34]), and a sleep diary (n = 35). We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep-diary-assisted actigraphy (AWS|SD). RESULTS Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (intraclass correlation [ICC]: going to bed, getting out of bed, time in bed >0.75), whereas the accuracy of AWS-A was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71 ± 81.16 minutes; Emfit: +101.47 ± 75.95 minutes) as did AWS-A (+46.95 ± 67.26 minutes). The CSTs overestimated sleep efficiency (WSA: +9.19% ± 14.26%; Emfit: +9.41% ± 11.05%), whereas AWS-A estimate (-2.38% ± 10.06%) was accurate. About 65% (n = 23) of participants reported daytime naps either in bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-hour sleep duration with an error of ≈10% compared to the sleep diary. CONCLUSIONS CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency, and naps before these CSTs can be fully utilized in field settings.
Collapse
Affiliation(s)
- Kiran K G Ravindran
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Ciro della Monica
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Damion Lambert
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Hana Hassanin
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
- Surrey Clinical Research Facility, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Victoria Revell
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| |
Collapse
|
7
|
Gueye-Ndiaye S, Williamson AA, Redline S. Disparities in Sleep-Disordered Breathing: Upstream Risk Factors, Mechanisms, and Implications. Clin Chest Med 2023; 44:585-603. [PMID: 37517837 PMCID: PMC10513750 DOI: 10.1016/j.ccm.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Sleep-disordered breathing (SDB) refers to a spectrum of disorders ranging from habitual snoring without frank episodes of obstructed breathing or desaturation during sleep to obstructive sleep apnea, where apneas and hypopneas repetitively occur with resultant intermittent hypoxia, arousal, and sleep disruption. Disparities in SDB reflect its overall high prevalence in children and adults from racially and ethnically minoritized or low socioeconomic status backgrounds coupled with high rates of underdiagnosis and suboptimal treatment.
Collapse
Affiliation(s)
- Seyni Gueye-Ndiaye
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Ariel A Williamson
- Children's Hospital of Philadelphia, 2716 South Street Boulevard, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan Redline
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA.
| |
Collapse
|
8
|
Taylor SA. Clinical Evaluation of the Sleepy and Sleepless Patient. Continuum (Minneap Minn) 2023; 29:1031-1044. [PMID: 37590821 DOI: 10.1212/con.0000000000001281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE This article addresses the approach to the evaluation of patients who present to a neurologist with excessive daytime sleepiness or difficulty sleeping. LATEST DEVELOPMENTS Greater emphasis on the importance of sleep reflects the growing scientific understanding that sleep is critical to overall health and well-being. Consumer sleep technologies, which measure parameters related to sleep, may provide insight into an individual's sleep-related symptoms and tendencies and have a role in patient-centered sleep evaluation when used within an appropriate clinical context. ESSENTIAL POINTS A thorough review of a patient's history and physical examination findings are important components of the assessment and management of their sleep-related symptoms. An understanding of how the clinical context relates to the categorization of sleep disorders can impact a patient's symptoms, comorbid neurologic disorders, and overall well-being. Many neurologic conditions are strongly associated with sleep disturbance, risk factors for the development of a sleep disorder, or both. Therefore, it is critical for neurologists to be familiar and comfortable with taking a focused sleep history. Modalities such as in-laboratory polysomnography, home sleep apnea testing, multiple sleep latency testing, and actigraphy, as well as contextualized and prudent use of data obtained from consumer sleep technologies, can be helpful in appropriately selected patients. Mindful integration of these objective data facilitates the diagnosis and management of sleep disorders.
Collapse
|
9
|
Hinnant B, Buckhalt JA, Brigham EF, Gillis BT, El-Sheikh M. Socioeconomic Disparities, Nighttime Bedroom Temperature, and Children's Sleep. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023; 86:101530. [PMID: 37035841 PMCID: PMC10081498 DOI: 10.1016/j.appdev.2023.101530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
We investigated associations between family income-to-needs, nighttime bedroom temperature (NBT), and children's sleep. Using a sample of 46 children (M age = 11.5), we recorded NBT and objective sleep parameters via actigraphy nightly for one week to evaluate within- (night-to-night) and between-person associations. We found consistent evidence for a curvilinear association between NBT and sleep variables at the between-person level, indicating that children who slept in rooms that were "too hot" or "too cold" experienced poorer sleep. Moreover, children in lower income-to-needs families had more extreme NBTs. There was some evidence that family income-to-needs is indirectly related to sleep via NBT, but with interpretational caveats. These findings point to NBT as a potentially modifiable variable, which has implications for practical applications to mitigate effects of socioeconomic disparities on children's sleep.
Collapse
Affiliation(s)
- Ben Hinnant
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL 36849
| | - Joseph A. Buckhalt
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL 36849
| | - Emily F. Brigham
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL 36849
| | - Brian T. Gillis
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL 36849
| | - Mona El-Sheikh
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL 36849
| |
Collapse
|
10
|
Yang E, Ismail A, Kim Y, Erdogmus E, Boron J, Goldstein F, DuBose J, Zimring C. Multidimensional Environmental Factors and Sleep Health for Aging Adults: A Focused Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15481. [PMID: 36497555 PMCID: PMC9739530 DOI: 10.3390/ijerph192315481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/28/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
The timing, amount, and quality of sleep are critical for an individual's health and quality of life. This paper provides a focused narrative review of the existing literature around multidimensional environments and sleep health for aging adults. Five electronic databases, Scopus, Web of Science, PubMed/Medline; EBSCOhost, PsycINFO (ProQuest), and Google Scholar yielded 54,502 total records. After removing duplicates, non-peer reviewed academic articles, and nonrelevant articles, 70 were included for review. We were able to categorize environmental factors into housing security, home environment, and neighborhood environment, and, within each environmental category, specific elements/aspects are discussed. This paper provides a comprehensive map connecting identified levels of influence (individual, home/house, and neighborhood-level) in which subfactors are listed under each level of influence/category with the related literature list. Our review highlights that multidimensional environmental factors can affect aging adults' sleep health and eventually their physical, mental, and cognitive health and that sleep disparities exist in racial minorities in socioeconomically disadvantaged communities in which cumulative environmental stressors coexist. Based on this focused narrative review on the multidimensional sleep environments for aging adults, knowledge gaps are identified, and future research directions are suggested.
Collapse
Affiliation(s)
- Eunhwa Yang
- School of Building Construction, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Aliaa Ismail
- School of Building Construction, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Yujin Kim
- School of Building Construction, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Ece Erdogmus
- School of Building Construction, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Julie Boron
- Department of Gerontology, University of Nebraska Omaha, Omaha, NE 68182, USA
| | - Felicia Goldstein
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Jennifer DuBose
- SimTigrate Design Lab, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Craig Zimring
- SimTigrate Design Lab, Georgia Institute of Technology, Atlanta, GA 30332, USA
| |
Collapse
|
11
|
Peltz JS, Rogge RD, Elmore-Staton L, Spilsbury J, Buckhalt JA. The development of a scale to assess children's and adolescents' sleep environments. J Clin Sleep Med 2022; 18:2353-2365. [PMID: 35702021 PMCID: PMC9516582 DOI: 10.5664/jcsm.10110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/03/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To develop a measure of children's sleep environments and to assess its initial reliability and validity. METHODS This cross-sectional study consisted of an online survey for parents of children ages 5-18 years across the United States. A total of 840 parents/caregivers (Mage = 40.6 years, standard deviation = 8.6; 72.0% female) completed surveys regarding a target child (Mage = 10.4 years, standard deviation = 3.8). The items on the scale that was developed were evaluated with exploratory and confirmatory factor analyses in separate random sample halves of the dataset. Cronbach's alpha coefficients were calculated to assess internal consistency across multiple demographic groups. We explored convergent and discriminant validity by examining associations with measures from the nomological net of constructs surrounding the children's sleep environment. Finally, we examined incremental/unique predictive validity of the full scale and its subscales through regression analyses. RESULTS The Children's and Adolescents' Sleep Environment Scale (13 items) produced 3 factors: general environmental hazards (7 items), availability of bedding materials (2 items), and presence of electronics (4 items). The full scale and its subscales showed strong discriminant validity, and analyses suggested that the Children's and Adolescents' Sleep Environment Scale and its subscales were generalizable across diverse demographic groups. Finally, after controlling for children's sleep hygiene, sleep disturbances, behavioral problems, and family functioning, the full-scale Children's and Adolescents' Sleep Environment Scale significantly predicted children's sleepiness, as did the general environmental hazards and presence of electronics subscales in a separate regression analysis. CONCLUSIONS The Children's and Adolescents' Sleep Environment Scale shows strong psychometric properties and has emerged as both a reliable and valid indicator of children's and adolescents' sleep environments and their potential impact on children's sleep and sleep-related behavior. CITATION Peltz JS, Rogge RD, Elmore-Staton L, Spilsbury J, Buckhalt JA. The development of a scale to assess children's and adolescents' sleep environments. J Clin Sleep Med. 2022;18(10):2353-2365.
Collapse
|
12
|
He L, Ma T, Li J, Luo Y, Zhang G, Cheng X, Bai Y. Adherence to a Healthy Sleep Pattern and Incidence of Cardiometabolic Multimorbidity Among Hypertensive Patients: A Prospective Study of UK Biobank. Sleep 2022; 45:6615411. [PMID: 35738866 PMCID: PMC9548671 DOI: 10.1093/sleep/zsac141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/13/2022] [Indexed: 11/15/2022] Open
Abstract
Study Objectives To investigate whether a healthy sleep pattern would reduce the risk of cardiometabolic multimorbidity (CMM) among hypertensives. Methods This is a prospective cohort analysis from the UK Biobank. A total of 69 524 hypertensives without a history of diabetes mellitus, coronary heart disease, or stroke at baseline were enrolled. Five dimensions of healthy sleep at baseline including early chronotype, sleep 7–8 h/d, free of insomnia, no snoring, and no frequent excessive daytime sleepiness were used to generate a healthy sleep score ranging from 0 to 5 (one point was given for each dimension of healthy sleep). A higher score indicated a healthier sleep pattern. We set five groups corresponding to the healthy sleep score of 5, 4, 3, 2, and 0–1, respectively. The primary outcome was the incidence of overall CMM among enrolled hypertensives. We assessed the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) by Fine-Gray subdistribution hazard models. Results We found the full-adjusted HR (95% CI) for overall CMM was 0.93 (0.91–0.95) for a 1-point increase in the healthy sleep score. Compared to hypertensives with a healthy sleep score of 0–1, those with a score of 5 had a 27% lower risk of overall CMM, and 37%, 23%, and 20% lower risks of diabetes mellitus, coronary heart disease, and stroke, respectively, after adjusting for sociodemographic characteristic, lifestyle, and clinical factors. Conclusions Our results indicated that a healthy sleep pattern was associated with lower risks of CMM outcomes among hypertensives.
Collapse
Affiliation(s)
- Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tianqi Ma
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jinchen Li
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Luo
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Guogang Zhang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China.,Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
13
|
Xu X, Lian Z. Objective sleep assessments for healthy people in environmental research: A literature review. INDOOR AIR 2022; 32:e13034. [PMID: 35622713 DOI: 10.1111/ina.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/04/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
To date, although many studies had focused on the impact of environmental factors on sleep, how to choose the proper assessment method for objective sleep quality was often ignored, especially for healthy subjects in bedroom environment. In order to provide methodological guidance for future research, this paper reviewed the assessments of objective sleep quality applied in environmental researches, compared them from the perspective of accuracy and interference, and statistically analyzed the impact of experimental type and subjects' information on method selection. The review results showed that, in contrast to polysomnography (PSG), the accuracy of actigraphy (ACT), respiratory monitoring-oxygen saturation monitoring (RM-OSM), and electrocardiograph (ECG) could reach up to 97%, 80.38%, and 79.95%, respectively. In terms of sleep staging, PSG and ECG performed the best, ACT the second, and RM-OSM the worst; as compared to single methods, mix methods were more accurate and better at sleep staging. PSG interfered with sleep a great deal, while ECG and ACT could be non-contact, and thus, the least interference with sleep was present. The type of experiment significantly influenced the choice of assessment method (p < 0.001), 85.3% of researchers chose PSG in laboratory study while 82.5% ACT in field study; moreover, PSG was often used in a relatively small number of young subjects, while ACT had a wide applicable population. In general, researchers need to pay more attention at selection of assessments in future studies, and this review can be used as a reliable reference for experimental design.
Collapse
Affiliation(s)
- Xinbo Xu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiwei Lian
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
14
|
McWood LM, Zeringue MM, Piñón OM, Buckhalt JA, El-Sheikh M. Linear and nonlinear associations between the sleep environment, presleep conditions, and sleep in adolescence: moderation by race and socioeconomic status. Sleep Med 2021; 93:90-99. [PMID: 34879983 PMCID: PMC9058149 DOI: 10.1016/j.sleep.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE/BACKGROUND The role of the sleep environment and presleep conditions that may influence adolescents' sleep are understudied. The aims of the current study were to examine linear and nonlinear associations between the sleep environment and presleep conditions and adolescents' daytime sleepiness and sleep/wake problems. METHOD Participants included 313 adolescents (Mage = 17.39 years, SD = 10.38 months; 51.4% girls, 48.6% boys; 59.1% White/European American, 40.3% Black/African American) from a wide range of socioeconomic backgrounds living in the southeastern United States. Adolescents completed surveys assessing the sleep environment (eg, light, bedding), four presleep conditions (ie, general worries, family concerns, arousal, somatic complaints), and sleep (daytime sleepiness, sleep/wake problems). RESULTS Sleep environment disruptions and worse presleep conditions were positively associated with sleepiness and sleep/wake problems in a linear fashion. Nonlinear associations emerged such that levels of sleepiness increased rapidly between low and average levels of the sleep environment and two presleep conditions (worries, arousal); the slope leveled off between average and high levels. Moreover, linear effects of environmental disruptions, family concerns, somatic complaints, and presleep arousal on sleep/wake problems were moderated by race and/or SES, indicating that positive associations between some presleep conditions and sleep/wake problems were more pronounced for Black and lower SES youth. CONCLUSIONS Results support the importance of the sleep environment and multiple presleep conditions and assessments of both linear and nonlinear effects for a better understanding of factors that may contribute to sleep. Additionally, results indicate the sleep environment and some presleep conditions may be more consequential for disadvantaged youth.
Collapse
Affiliation(s)
- Leanna M McWood
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA
| | - Megan M Zeringue
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - Olivia Martín Piñón
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA
| | - Joseph A Buckhalt
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA.
| |
Collapse
|