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Barber LE, McCullough LE, Johnson DA. Eyes Wide Open: Sleep as a Potential Contributor to Racial and Ethnic Disparities in Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:471-479. [PMID: 38270540 PMCID: PMC10990828 DOI: 10.1158/1055-9965.epi-23-1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/05/2023] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
U.S. racial and ethnic minoritized groups face disproportionate cancer burdens compared to White Americans. Investigating modifiable factors, such as sleep, that are socially patterned and inequitably distributed by race and ethnicity may advance understanding of cancer disparities and provide intervention opportunities. Emerging data suggest poor sleep health is associated with cancer. Yet, its contribution to racial and ethnic cancer disparities is understudied. In this narrative review, we explored the sleep-cancer relation through a disparities lens. We (i) summarized literature reporting on associations between sleep and cancer among racial and ethnic minority populations; (ii) examined potential sleep-cancer mechanisms; and (iii) discussed future directions. We identified five studies reporting on sleep-cancer associations among minoritized groups. Poor sleep health was associated with aggressive breast cancer among Black women, increased breast cancer risk among Asian women, and increased risk of breast and total cancer among Hispanic/Latinx Americans. Sleep and cancer disparities have similar socioeconomic and behavioral determinants, suggesting racial and ethnic minoritized groups may be vulnerable to poor sleep health and its adverse health impacts. Evidence indicates that the sleep-cancer disparities relation is an emerging, but important area of research that warrants further investigation, as sleep may be an avenue for reducing cancer disparities.
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Affiliation(s)
- Lauren E. Barber
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Lauren E. McCullough
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Dayna A. Johnson
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Edmed SL, Huda MM, Pattinson CL, Rossa KR, Smith SS. Perceived Neighborhood Characteristics and Sleep in Australian Adults. Health Educ Behav 2024; 51:155-166. [PMID: 37306016 PMCID: PMC10785564 DOI: 10.1177/10901981231177687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Poor sleep can contribute to poorer health and socioemotional outcomes. Sleep health can be influenced by a range of individual and other socioecological factors. Perceptions of neighborhood physical and social characteristics reflect broader social-level factors that may influence sleep, which have not been well studied in the Australian context. This study examined the association between perceived neighborhood characteristics and sleep in a large sample of Australians. METHODS Data were from 9,792 people aged 16 years or older, from Waves 16 and 17 of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Associations between perceived neighborhood characteristics (neighborly interaction and support, environmental noise, physical condition, and insecurity) and self-reported sleep duration, sleep disturbance, and napping were examined using multiple logistic regression models. RESULTS "Neighborhood interaction and support" and "neighborhood physical condition" were not significantly associated with any sleep outcomes after adjusting for relevant covariates. However, "environmental noise" and "neighborhood insecurity" remained significantly associated with sleep duration and sleep disturbance. None of the neighborhood characteristics were associated with napping. Furthermore, associations did not significantly vary by gender. CONCLUSIONS This study highlights the potential benefit of public health policies to address noise and safety in neighborhoods to improve sleep.
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Affiliation(s)
- Shannon L Edmed
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - M Mamun Huda
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Cassandra L Pattinson
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for the Digital Child, The University of Queensland, Brisbane, Queensland, Australia
| | - Kalina R Rossa
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Simon S Smith
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for the Digital Child, The University of Queensland, Brisbane, Queensland, Australia
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3
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Reffi AN, Kalmbach DA, Cheng P, Drake CL. The sleep response to stress: how sleep reactivity can help us prevent insomnia and promote resilience to trauma. J Sleep Res 2023; 32:e13892. [PMID: 37020247 DOI: 10.1111/jsr.13892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 04/07/2023]
Abstract
Sleep reactivity is a predisposition to sleep disturbance during environmental perturbations, pharmacological challenges, or stressful life events. Consequently, individuals with highly reactive sleep systems are prone to insomnia disorder after a stressor, engendering risk of psychopathology and potentially impeding recovery from traumatic stress. Thus, there is tremendous value in ameliorating sleep reactivity to foster a sleep system that is robust to stress exposure, ultimately preventing insomnia and its downstream consequences. We reviewed prospective evidence for sleep reactivity as a predisposition to insomnia since our last review on the topic in 2017. We also reviewed studies investigating pre-trauma sleep reactivity as a predictor of adverse post-traumatic sequelae, and clinical trials that reported the effect of behavioural treatments for insomnia on mitigating sleep reactivity. Most studies measured sleep reactivity via self-report using the Ford Insomnia Response to Stress Test (FIRST), demonstrating high scores on this scale reliably indicate a sleep system with a lower capacity to tolerate stress. Nascent evidence suggests elevated sleep reactivity prior to trauma increases the risk of negative posttraumatic outcomes, namely acute stress disorder, depression, and post-traumatic stress disorder. Lastly, sleep reactivity appears most responsive to behavioural insomnia interventions when delivered early during the acute phase of insomnia. Overall, the literature strongly supports sleep reactivity as a premorbid vulnerability to incident acute insomnia disorder when faced with an array of biopsychosocial stressors. The FIRST identifies individuals at risk of insomnia a priori, thereby guiding early interventions toward this vulnerable population to prevent insomnia and promote resilience to adversity.
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Affiliation(s)
- Anthony N Reffi
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, Michigan, USA
| | - David A Kalmbach
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, Michigan, USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, Michigan, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, Michigan, USA
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Kim B, Troxel WM, Dubowitz T, Hunter GP, Ghosh-Dastidar B, Chaix B, Rudolph KE, Morrison CN, Branas CC, Duncan DT. Neighborhood Built Environment and Sleep Health: A Longitudinal Study in Low-Income and Predominantly African-American Neighborhoods. Am J Epidemiol 2023; 192:736-747. [PMID: 36691683 PMCID: PMC10423630 DOI: 10.1093/aje/kwad016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/10/2022] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
In the present study, we examined the associations between physical characteristics of neighborhoods and sleep health outcomes and assessed the mediating role of physical activity in these associations. A longitudinal study (the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health (PHRESH) Zzz Study; n = 1,051) was conducted in 2 low-income, predominately African-American neighborhoods in Pittsburgh, Pennsylvania, with repeated measures of neighborhood characteristics and sleep health outcomes from 2013 to 2018. Built environment measures of walkability, urban design, and neighborhood disorder were captured from systematic field observations. Sleep health outcomes included insufficient sleep, sleep duration, wakefulness after sleep onset, and sleep efficiency measured from 7-day actigraphy data. G-computations based on structural nested mean models were used to examine the total effects of each built environment feature, and causal mediation analyses were used to evaluate direct and indirect effects operating through physical activity. Urban design features were associated with decreased wakefulness after sleep onset (risk difference (RD) = -1.26, 95% confidence interval (CI): -4.31, -0.33). Neighborhood disorder (RD = -0.46, 95% CI: -0.86, -0.07) and crime rate (RD = -0.54, 95% CI: -0.93, -0.08) were negatively associated with sleep efficiency. Neighborhood walkability was not associated with sleep outcomes. We did not find a strong and consistent mediating role of physical activity. Interventions to improve sleep should target modifiable factors, including urban design and neighborhood disorder.
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Affiliation(s)
- Byoungjun Kim
- Correspondence to Dr. Byoungjun Kim, Department of Population Health, Grossman School of Medicine, New York University, 180 Madison Avenue, 5th Floor, New York, NY 10016 (e-mail: )
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Abstract
Sleep is essential to human survival and overall vascular health. Sleep health encompasses the objective and subjective qualities associated with one's daily pattern of sleep and wakefulness and has become a growing clinical and public health concern. Impaired sleep duration and quality can increase stroke risk and mediate the relationship between the physical aspects of an individual's environment and disparities in stroke incidence. Here, we review observational studies evaluating the association between sleep health and cerebrovascular disease. We assess the influence on sleep of the physical environment, including the ambient environment with noise levels and the built environment. We also describe the influences on sleep health and stroke risk of social determinants of health, including the chronic stressor of racial discrimination. Finally, we discuss how changes in historical neighborhood characteristics or societal policies can influence the social factors affecting sleep health and stroke risk among socioeconomically disadvantaged groups or ethnic and racial minorities. Given the regional and racial or ethnic differences in stroke risk across the United States, an understanding of novel vascular risk factors, such as the multifaceted role of sleep health, will be critical to develop effective public policies to improve population health.
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Affiliation(s)
- Sandeep P Khot
- Department of Neurology (S.P.K., B.L.T., W.T.L.), University of Washington, Seattle
| | - Breana L Taylor
- Department of Neurology (S.P.K., B.L.T., W.T.L.), University of Washington, Seattle
| | - W T Longstreth
- Department of Neurology (S.P.K., B.L.T., W.T.L.), University of Washington, Seattle
- Department of Epidemiology (W.T.L.), University of Washington, Seattle
| | - Arleen F Brown
- Department of Medicine, University of California, Los Angeles (A.F.B.)
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Spadola C, Groton DB, Littlewood K, Hilditch C, Burke S, Bertisch SM. Sleep Health Education to Promote Public Health: Attitudes and Desired Learning Goals among Social Work Students. Soc Work Public Health 2023; 38:11-20. [PMID: 35758038 DOI: 10.1080/19371918.2022.2093304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Social workers are often front line behavioral health providers for underserved populations, many of whom experience sleep disturbances. Inadequate sleep presents a public health challenge and is associated with many adverse physical health and mental health consequences. Social workers are uniquely positioned to promote sleep health among individuals experiencing health inequities. However, sleep is rarely included as part of the curricula in social work programs in the U.S. We conducted qualitative formative research to investigate social work students' perceptions of sleep education and desired sleep learning objectives. Twenty-five social work students were recruited via a listserv e-mail to participate in one of three focus groups. Participants believed sleep education could be beneficial in promoting client health and well-being. Desired learning goals included: (1) the importance of sleep; (2) identify symptoms of sleep deprivation and sleep disorders; (3) environmental and lifestyle factors that impact sleep; (4) behaviors to promote optimal sleep; and (5) sleep health as it relates to special populations (e.g., homelessness, substance using). Social work students expressed a desire to aquire knowledge on sleep health promotion as part of the social work curricula. Sleep education could be of considerable relevance to social work students, practitioners, and the clients they serve.
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Affiliation(s)
- Christine Spadola
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | - Danielle B Groton
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | | | - Cassie Hilditch
- Fatigue Countermeasures Laboratory, San José State University, San José, CA, USA
| | - Shanna Burke
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Suzanne M Bertisch
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, USA
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7
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Segrin C, Jiao J, Cooper RA. Neighborhood Disadvantage and Mental Health: Test of a Parallel Mediation Model through Social Support and Negative Emotionality. Health Commun 2022; 37:1581-1589. [PMID: 33761820 DOI: 10.1080/10410236.2021.1903733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
According to the life stress model, stressful circumstances occur in the context of social, psychological, and environmental features that can function as either resources or aggravating factors, each of which are associated with well-being. This research was designed to test indirect effects of living in disadvantaged neighborhoods on mental health, through reduced social support and increased negative emotionality. This model was tested with data from a national sample of 1050 adults residing in the United States. Participants completed measures of social support, negative emotionality, depression, loneliness, stress, and alcohol consumption. These scores were merged with data from the 2015 American Community Survey to assess indicators of neighborhood disadvantage at the zip code level. The test of a parallel mediation model with structural equation modeling indicated that neighborhood disadvantage did not have direct effects on either psychological distress or alcohol consumption. However, neighborhood disadvantage was associated with greater negative emotionality, and through negative emotionality, exhibited indirect effects on psychological distress and alcohol consumption. These results are consistent with elements of the life stress model that specify various psychosocial traits as maladaptive in the context of stressful environments.
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Affiliation(s)
- Chris Segrin
- Department of Communication, University of Arizona
| | - Jian Jiao
- Department of Communication, University of Arizona
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Young DR, Hong BD, Lewis KH, Paz SR, Bhakta BB, Macias M, Crawford CL, Drewnowski A, Ji M, Moore DD, Shen E, Murali SB, Coleman KJ. The association of 1-year weight loss from bariatric surgery and self-reported sleep: a prospective cohort. Obesity (Silver Spring) 2022; 30:2307-2316. [PMID: 36321277 PMCID: PMC9913885 DOI: 10.1002/oby.23543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors. METHODS Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI component scores with separate cumulative logit models. RESULTS There were 997 participants in the analytic cohort. Participants were 86.2% women, 37.0% Hispanic, and 13.7% Black adults. Mean one-year %TWL was 26.3 (SD 8.7). Each 1% increase in %TWL was associated with a 3% better daytime dysfunction score (odds ratio = 1.03; 95% CI: 1.02-1.05) and a 2% better sleep quality score (odds ratio = 1.02; 95% CI: 1.00-1.03). No significant differences were found for the other PSQI components. CONCLUSIONS Weight loss from bariatric surgery was associated with better self-reported sleep at 1 year. For people undergoing bariatric surgery, there may be an added benefit of better sleep.
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Affiliation(s)
- Deborah R. Young
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Benjamin D. Hong
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Kristina H. Lewis
- Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA
| | - Silvia R. Paz
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Bhumi B. Bhakta
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Mayra Macias
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Cecelia L. Crawford
- Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - Darren D. Moore
- Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, Illinois, USA
| | - Ernest Shen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Sameer B. Murali
- Center for Obesity Medicine & Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Karen J. Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
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9
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Lucchini M, O’Brien LM, Kahn LG, Brennan PA, Glazer Baron K, Knapp EA, Lugo-Candelas C, Shuffrey L, Dunietz GL, Zhu Y, Wright RJ, Wright RO, Duarte C, Karagas MR, Ngai P, O’Connor TG, Herbstman JB, Dioni S, Singh AM, Alcantara C, Fifer WP, Elliott AJ. Racial/ethnic disparities in subjective sleep duration, sleep quality, and sleep disturbances during pregnancy: an ECHO study. Sleep 2022; 45:zsac075. [PMID: 35724979 PMCID: PMC9453625 DOI: 10.1093/sleep/zsac075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/23/2022] [Indexed: 01/10/2023] Open
Abstract
In the United States, racial/ethnic minoritized groups experience worse sleep than non-Hispanic Whites (nHW), but less is known about pregnant people. This is a key consideration since poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. This study reports the prevalence of subjective sleep measures in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program. Participants' self-reported race and ethnicity were grouped into: nHW, non-Hispanic Black/African American (nHB/AA), Hispanic, non-Hispanic Asian (nHA). Analyses examined trimester-specific (first (T1), second (T2), third (T3)) nocturnal sleep duration, quality, and disturbances (Pittsburgh Sleep Quality Index and ECHO maternal sleep health questionnaire). Linear or multinomial regressions estimated the associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index and age, with nHW as reference group. We repeated analyses within maternal education strata. nHB/AA participants reported shorter sleep duration (T2: β = -0.55 [-0.80,-0.31]; T3: β = -0.65 [-0.99,-0.31]) and more sleep disturbances (T2: β = 1.92 [1.09,2.75]; T3: β = 1.41 [0.09,2.74]). Hispanic participants reported longer sleep duration (T1: β = 0.22 [0.00004,0.44]; T2: β = 0.61 [0.47,0.76]; T3: β = 0.46 [0.22,0.70]), better sleep quality (Reference group: Very good. Fairly good T1: OR = 0.48 [0.32,0.73], T2: OR = 0.36 [0.26,0.48], T3: OR = 0.31 [0.18,0.52]. Fairly bad T1: OR = 0.27 [0.16,0.44], T2: OR = 0.46 [0.31, 0.67], T3: OR = 0.31 [0.17,0.55]), and fewer sleep disturbances (T2: β = -0.5 [-1.0,-0.12]; T3: β = -1.21 [-2.07,-0.35]). Differences persisted within the high-SES subsample. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities.
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Affiliation(s)
- Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Louise M O’Brien
- Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Kelly Glazer Baron
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Claudia Lugo-Candelas
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Lauren Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Galit Levi Dunietz
- Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cristiane Duarte
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Pakkay Ngai
- Division of Pediatric Pulmonology, Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Thomas G O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, New York NY, USA
| | - Sean Dioni
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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Hedin G, Norell-Clarke A, Tønnesen H, Westergren A, Garmy P. Contributory Factors for Teen Insomnia Symptoms: A Prospective Cohort Study in Sweden. Front Neurosci 2022; 16:904974. [PMID: 35837125 PMCID: PMC9275817 DOI: 10.3389/fnins.2022.904974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Insufficient sleep is a public health problem that impacts the mental and physical health of children and adolescents. Complaints of insomnia are particularly pervasive among adolescents. This longitudinal study investigates factors that contribute to teen insomnia symptoms. Design Five-year prospective follow-up study. Setting School-based. Participants A total of 522 children (49.8% girls) aged 9.4 ± 1.3 years at baseline; 14.4 ± 0.7 years at follow-up. Measurements The dependent variable of insomnia symptoms at follow-up was assessed with the Minimal Insomnia Symptom Scale-Revised. The independent variables at baseline were the perceived family financial situation, tiredness at school, problems waking up, short sleep duration, sleeping difficulties, having a bedroom Television (TV), and time spent with a TV/computer. Multivariate binary logistic regression analyses were used to examine whether the independent variables at baseline predicted insomnia symptoms at follow-up. Results Perceived quite bad/very bad family financial situation (OR 3.1; CI 1.4–6.7) and short sleep duration (<10 h) (OR 2.3; CI 1.0–5.3) among girls at baseline were associated with insomnia symptoms at follow-up. Having problems waking up among boys at baseline was associated with insomnia symptoms at follow-up (OR 4.9; CI 1.6–14.4). Conclusion Short sleep duration, problems waking up, and perceived bad family financial situation during childhood were linked with adolescent insomnia symptoms. The sex-based differences in these associations warrant further investigation to effectively mitigate adolescent insomnia.
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Affiliation(s)
- Gita Hedin
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Clinical Health Promotion Centre, WHO-Collaborating Centre, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- *Correspondence: Gita Hedin,
| | - Annika Norell-Clarke
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Hanne Tønnesen
- Clinical Health Promotion Centre, WHO-Collaborating Centre, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Albert Westergren
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Clinical Health Promotion Centre, WHO-Collaborating Centre, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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11
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Kim B, Troxel WM, Dubowitz T, Hunter GP, Ghosh-Dastidar B, Chaix B, Rudolph KE, Morrison CN, Branas CC, Duncan DT. Mediating role of psychological distress in the associations between neighborhood social environments and sleep health. Sleep 2022; 45:6568592. [PMID: 35421893 PMCID: PMC9366649 DOI: 10.1093/sleep/zsac087] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/21/2022] [Indexed: 01/14/2023] Open
Abstract
STUDY OBJECTIVES The characteristics of neighborhood social environments, such as safety and social cohesion, have been examined as determinants of poor sleep. The current study investigates associations between neighborhood social characteristics and sleep health, as well as the mediating role of psychological distress on these possible associations. METHODS Three waves of PHRESH Zzz (n = 2699), a longitudinal study conducted in two low-income, predominately Black neighborhoods, were utilized for this analysis. The characteristics of neighborhood social environments were measured using crime rates, a neighborhood social disorder index, and self-reported social cohesion. Sleep health was measured via 7 days of wrist-worn actigraphy as insufficient sleep, sleep duration, wake after sleep onset (WASO), and sleep efficiency. G-estimations based on structural nested mean models and mediation analyses were performed to estimate the effects of neighborhood social environments on sleep as well as direct/indirect effects through psychological distress. RESULTS Crime rate around residential addresses was associated with increased risk of insufficient sleep (risk ratio: 1.05 [1.02, 1.12]), increased WASO (β: 3.73 [0.26, 6.04]), and decreased sleep efficiency (β: -0.54 [-0.91, -0.09]). Perceived social cohesion was associated with decreased risk of insufficient sleep (OR: 0.93 [0.88, 0.97]). Psychological distress mediated part of the associations of crime and social cohesion with insufficient sleep. CONCLUSIONS Neighborhood social environments may contribute to poor sleep health in low-income, predominantly Black neighborhoods, and psychological distress can be a salient pathway linking these neighborhood characteristics and sleep health.
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Affiliation(s)
- Byoungjun Kim
- Corresponding author. Byoungjun Kim, Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave 5th Floor, New York, NY 10016, USA.
| | | | | | | | | | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique IPLESP, Nemesis Team, Paris, France
| | - Kara E Rudolph
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Christopher N Morrison
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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12
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Kim B, Branas CC, Rudolph KE, Morrison CN, Chaix B, Troxel WM, Duncan DT. Neighborhoods and sleep health among adults: A systematic review. Sleep Health 2022; 8:322-333. [DOI: 10.1016/j.sleh.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
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13
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Testa A, Fahmy C, Hill TD. Perceptions of neighborhood dangerousness and changes in sleep quality during the COVID-19 pandemic: Assessing the mediating role of changes in health behaviors. Prev Med 2022; 156:106991. [PMID: 35167855 PMCID: PMC8837485 DOI: 10.1016/j.ypmed.2022.106991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/02/2021] [Accepted: 02/06/2022] [Indexed: 11/25/2022]
Abstract
Numerous studies have demonstrated that neighborhood context contributes to variations in morbidity and mortality. This body of work includes a burgeoning literature that links adverse neighborhood characteristics (e.g., neighborhood poverty and perceptions of disorder and dangerousness) with poorer sleep outcomes. During the COVID-19 pandemic, many neighborhoods exhibited socioeconomic downturns and escalations in crime and violence. The question is the extent to which these changes in neighborhood conditions have impacted the sleep quality of residents. In this paper, we use original survey data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of adults living in the U.S., to formally test whether changes in perceptions of neighborhood dangerousness during the pandemic are associated with sleep quality during the same period. Regression analyses show that while reports of a neighborhood becoming safer during the pandemic are associated with better sleep quality, reports of a neighborhood becoming more dangerous are associated with worse sleep quality. Mediation analyses also indicate that the association between increased neighborhood dangerousness and poorer sleep quality is partially explained by a concurrent deterioration in diet quality, but not increases in alcohol or cigarette consumption. We conclude with a discussion of the implications of our findings for research and policy on neighborhood context and sleep.
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Affiliation(s)
- Alexander Testa
- University of Texas at San Antonio, Department of Criminology & Criminal Justice, United States of America.
| | - Chantal Fahmy
- University of Texas at San Antonio, Department of Criminology & Criminal Justice, United States of America.
| | - Terrence D Hill
- University of Texas at San Antonio, Department of Sociology, United States of America.
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14
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Okoye SM, Spira AP, Perrin NA, Schrack JA, Han HR, Wanigatunga S, Nyhuis C, Szanton SL. Exterior housing conditions are associated with objective measures of poor sleep among low-income older adults with disabilities. Sleep Health 2021; 7:731-734. [PMID: 34629322 DOI: 10.1016/j.sleh.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine the association of housing and neighborhood conditions with sleep among disadvantaged older adults. METHODS We used data from 136 low-income, predominantly Black older adults with disabilities. Predictors were indices of: interior housing conditions (eg, pests, tripping hazards); exterior housing conditions (eg, broken windows); and neighborhood disorder (eg, litter, vacant buildings). Outcomes were actigraphic total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). RESULTS In models adjusted for age, sex, education, living arrangement, comorbidities, and physical performance, each additional exterior housing problem was associated with 20.9-minutes less TST (95% confidence interval [CI]: -39.2, -2.6), 8.6-minutes more WASO (95% CI: 0.7, 16.5), and 2.3% lower SE (95% CI: -4.2, -0.4). The associations of interior housing conditions and neighborhood disorder with the sleep parameters were of smaller magnitude and not statistically significant. CONCLUSIONS Future studies should examine the effects of housing repair on sleep health.
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Affiliation(s)
- Safiyyah M Okoye
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA.
| | - Adam P Spira
- Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Nancy A Perrin
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hae-Ra Han
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sarah Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Casandra Nyhuis
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
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15
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Bozick R, Troxel WM, Karoly LA. Housing insecurity and sleep among welfare recipients in California. Sleep 2021; 44:6124109. [PMID: 33523227 DOI: 10.1093/sleep/zsab005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/21/2020] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES To estimate the effect of housing insecurity on sleep duration and sleep quality. METHODS Using longitudinal data from a sample of 1,046 welfare recipients in the state of California followed from 2015-2016 through 2017-2018, we regressed self-reported measures of sleep duration and sleep quality recorded in 2017-2018 on experiences of housing insecurity in the prior year. We applied propensity score weights to attenuate potential bias from an array of observed covariates, including sleep duration and sleep quality measured prior to experiences with housing insecurity. RESULTS Sample members who were unable to make their rent/mortgage payments slept on average 22 fewer minutes a night and had lower quality sleep than those who were able to make their rent/mortgage payments. Sample members who were forced to move because of an inability to make rent/mortgage payments slept on average 32 fewer minutes a night and had lower quality sleep than those who were not forced to move. CONCLUSIONS By compromising sleep health, housing insecurity represents a distinct form of stress in the lives of economically-disadvantaged adults, which could also contribute to other health disparities.
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Affiliation(s)
- Robert Bozick
- Kinder Institute for Urban Research, Rice University, Houston, TX, USA
| | - Wendy M Troxel
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PA, USA
| | - Lynn A Karoly
- Department of Economics, Sociology, and Statistics RAND Corporation, Washington, DC, USA
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16
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Johnson DA, Jackson CL, Guo N, Sofer T, Laden F, Redline S. Perceived Home Sleep Environment: Associations of Household-level Factors and In-bed Behaviors with Actigraphy-based Sleep Duration and Continuity in the Jackson Heart Sleep Study. Sleep 2021; 44:6324609. [PMID: 34283244 PMCID: PMC8678916 DOI: 10.1093/sleep/zsab163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES In an older African-American sample (n=231) we tested associations of the household environment and in-bed behaviors with sleep duration, efficiency, and wakefulness after sleep onset (WASO). METHODS Older adult participants completed a household-level sleep environment questionnaire, a sleep questionnaire, and underwent 7-day wrist actigraphy for objective measures of sleep. Perceived household environment (self-reported) was evaluated using questions regarding safety, physical comfort, temperature, noise, and light disturbances. In-bed behaviors included: watching television, listening to radio/music, use of computer/tablet/phone, playing video games, reading books, and eating. To estimate the combined effect of the components in each domain (perceived household environment and in-bed behaviors), we calculated and standardized a weighted score per sleep outcome (e.g., duration, efficiency, WASO), with a higher score indicating worse conditions. The weights were derived from the coefficients of each component estimated from linear regression models predicting each sleep outcome while adjusting for covariates. RESULTS A standard deviation increase in an adverse household environment score was associated with lower self-reported sleep duration (β=-13.9 minutes, 95% confidence interval: -21.6, -1.7) and actigraphy-based sleep efficiency (β=-0.7%, -1.4, 0.0). A standard deviation increase in the in-bed behaviors score was associated with lower actigraphy-based sleep duration (β=-9.7 minutes, -18.0, -1.3), sleep efficiency (β=-1.2%, -0.9, -0.6), and higher WASO (5.3 minutes, 2.1, 8.6). CONCLUSION Intervening on the sleep environment, including healthy sleep practices, may improve sleep duration and continuity among African-Americans.
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Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta GA USA.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston MA USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 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
| | - Na Guo
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston MA USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston MA USA.,Division of Sleep Medicine, Harvard Medical School, Boston MA USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA USA.,Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston MA USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston MA USA.,Division of Sleep Medicine, Harvard Medical School, Boston MA USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA USA
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17
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Mayne SL, Morales KH, Williamson AA, Grant SFA, Fiks AG, Basner M, Dinges DF, Zemel BS, Mitchell JA. Associations of the residential built environment with adolescent sleep outcomes. Sleep 2021; 44:6121932. [PMID: 33507268 DOI: 10.1093/sleep/zsaa276] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/02/2020] [Indexed: 01/13/2023] Open
Abstract
STUDY OBJECTIVES Over 75% of US high school students obtain insufficient sleep, placing them at risk for adverse health outcomes. Identification of modifiable determinants of adolescent sleep is needed to inform prevention strategies, yet little is known about the influence of the built environment on adolescent sleep. METHODS In this prospective study, actigraphy was used to assess sleep outcomes among 110 adolescents for 14 days each in eighth and ninth grades: duration (hours/night), onset and offset, and sleeping ≥8 hours. Home addresses were linked to built environment exposures: sound levels, tree canopy cover, street density, intersection density, population density, and housing density. Mixed-effects regression estimated associations of built environment measures with sleep outcomes, adjusting for sex, race, parent education, household income, household size, grade, weeknight status, and neighborhood poverty. RESULTS A 1-standard deviation (SD) increase in neighborhood sound was associated with 16 minutes later sleep onset (β = 0.28; 95% confidence interval (CI): 0.06, 0.49) and 25% lower odds of sleeping for ≥8 hours (odds ratio (OR) = 0.75, 95% CI: 0.59, 0.96). A 1-SD increase in neighborhood tree canopy was associated with 18 minutes earlier sleep onset (β = -0.31, 95% CI: -0.49, -0.13) and 10 minutes earlier sleep offset (β= -0.17, 95% CI: -0.28, -0.05). No associations were observed for density-based exposures. CONCLUSIONS Higher neighborhood sound level was associated with lower odds of sufficient sleep, while higher tree canopy cover was associated with more favorable sleep timing. Neighborhood sound levels and tree canopy cover are potential targets for policies and interventions to support healthier sleep among adolescents.
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Affiliation(s)
- Stephanie L Mayne
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.,Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Knashawn H Morales
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ariel A Williamson
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.,Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA.,Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Sleep Center, Children's Hospital of Philadelphia, Philadelphia, PA.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Struan F A Grant
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Center for Spatial and Functional Genomics, Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Alexander G Fiks
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Mathias Basner
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David F Dinges
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Babette S Zemel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA
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18
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Rumble DD, O'Neal K, Overstreet DS, Penn TM, Jackson P, Aroke EN, Sims AM, King AL, Hasan FN, Quinn TL, Long DL, Sorge RE, Goodin BR. Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals. J Behav Med 2021; 44:811-821. [PMID: 34106368 DOI: 10.1007/s10865-021-00234-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 06/03/2021] [Indexed: 02/08/2023]
Abstract
Individuals with chronic low back pain (cLBP) frequently report sleep disturbances. Living in a neighborhood characterized by low-socioeconomic status (SES) is associated with a variety of negative health outcomes, including poor sleep. Whether low-neighborhood SES exacerbates sleep disturbances of people with cLBP, relative to pain-free individuals, has not previously been observed. This study compared associations between neighborhood-level SES, pain-status (cLBP vs. pain-free), and daily sleep metrics in 117 adults (cLBP = 82, pain-free = 35). Neighborhood-level SES was gathered from Neighborhood Atlas, which provides a composite measurement of overall neighborhood deprivation (e.g. area deprivation index). Individuals completed home sleep monitoring for 7-consecutive days/nights. Neighborhood SES and pain-status were tested as predictors of actigraphic sleep variables (e.g., sleep efficiency). Analyses revealed neighborhood-level SES and neighborhood-level SES*pain-status interaction significantly impacted objective sleep quality. These findings provide initial support for the negative impact of low neighborhood-level SES and chronic pain on sleep quality.
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Affiliation(s)
- Deanna D Rumble
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA.
| | | | - Demario S Overstreet
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Terence M Penn
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Pamela Jackson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edwin N Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew M Sims
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Annabel L King
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Fariha N Hasan
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Tammie L Quinn
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - D Leann Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert E Sorge
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 237B, Birmingham, AL, 35294, USA
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19
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Combs D, Hsu CH, Bailey O, Patel SI, Mashaqi S, Estep L, Provencio-Dean N, Lopez S, Parthasarathy S. Differences in sleep timing and related effects between African Americans and non-Hispanic Whites. J Clin Sleep Med 2021; 17:897-908. [PMID: 33382030 PMCID: PMC8320474 DOI: 10.5664/jcsm.9060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 12/25/2022]
Abstract
STUDY OBJECTIVES Prior studies have shown a morning chronotype for African Americans compared with non-Hispanic Whites, yet self-reported sleep timing is delayed in African Americans compared with Whites. METHODS We analyzed data from the Multi-Ethnicity Study of Atherosclerosis, a multisite community-based cohort. Self-reported and actigraphic sleep timing, chronotype measured by the modified Horne-Östberg Morningness-Eveningness Questionnaire, and risk of depression measured by the Center for Epidemiologic Studies Depression scale were examined using nonparametric approaches and linear or logistic regression while comparing between African Americans and Whites and evaluating the effects of delayed sleep phase. RESULTS In 1,401 participants, there was no difference in chronotype between African Americans and Whites. African Americans were 80% more likely to report a delayed sleep phase (defined as bedtime after midnight) on weekdays and 50% more likely on weekends than were Whites. Actigraphic data showed similar results. Actigraphic midsleep time was delayed 38 minutes on weekdays and 24 minutes on weekends in African Americans compared with Whites. Stratified analysis by chronotype showed that African Americans with a morning or intermediate chronotype had a significantly delayed sleep phase compared with Whites, but there was no difference between African Americans and Whites with an evening chronotype. Delayed sleep phase was associated with depression, but this relationship was only significant in White participants. CONCLUSIONS African Americans had a delayed sleep phase compared with Whites that was more pronounced in individuals with a morning or intermediate chronotype. Consequences of delayed sleep phase may vary by race and ethnicity.
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Affiliation(s)
- Daniel Combs
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
- Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, Tucson, Arizona
| | - Omavi Bailey
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Salma I. Patel
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Saif Mashaqi
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Lauren Estep
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Natalie Provencio-Dean
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Silvia Lopez
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Sairam Parthasarathy
- UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
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20
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Amiruzzaman M, Curtis A, Zhao Y, Jamonnak S, Ye X. Classifying crime places by neighborhood visual appearance and police geonarratives: a machine learning approach. J Comput Soc Sci 2021; 4:813-837. [PMID: 33718652 PMCID: PMC7938887 DOI: 10.1007/s42001-021-00107-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 02/23/2021] [Indexed: 05/21/2023]
Abstract
The complex interrelationship between the built environment and social problems is often described but frequently lacks the data and analytical framework to explore the potential of such a relationship in different applications. We address this gap using a machine learning (ML) approach to study whether street-level built environment visuals can be used to classify locations with high-crime and lower-crime activities. For training the ML model, spatialized expert narratives are used to label different locations. Semantic categories (e.g., road, sky, greenery, etc.) are extracted from Google Street View (GSV) images of those locations through a deep learning image segmentation algorithm. From these, local visual representatives are generated and used to train the classification model. The model is applied to two cities in the U.S. to predict the locations as being linked to high crime. Results show our model can predict high- and lower-crime areas with high accuracies (above 98% and 95% in first and second test cities, accordingly).
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Affiliation(s)
| | | | - Ye Zhao
- Kent State University, Kent, USA
| | | | - Xinyue Ye
- Texas A & M University, College Station, USA
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21
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Dong L, Dubowitz T, Haas A, Ghosh-Dastidar M, Holliday SB, Buysse DJ, Hale L, Gary-Webb TL, Troxel WM. Prevalence and correlates of obstructive sleep apnea in urban-dwelling, low-income, predominantly African-American women. Sleep Med 2020; 73:187-195. [PMID: 32846281 DOI: 10.1016/j.sleep.2020.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVES The current study examined the prevalence and correlates of obstructive sleep apnea in a sample of low-income, predominantly African-American women using two waves of data. METHODS Participants were adults from two urban neighborhoods who enrolled in the PHRESH Zzz Study (N = 828; Pittsburgh Hill/Homewood Research on Neighborhoods, Sleep, and Health). A subsample who reported never receiving OSA diagnosis completed home sleep apnea testing in 2016 (n = 269, mean age 55.0 years, 79.6% female) and again in 2018 (n = 135). Correlates of OSA tested included demographic and anthropometric variables, health behavior/conditions, psychological distress and general health, smoking status, actigraphy-measured sleep, and neighborhood factors measured at baseline. RESULTS 18.0% of all 2016 participants reported receiving physician diagnoses of OSA. Among those who completed in-home assessment, 19.3% had AHI ≥15 and 33.8% had AHI ≥5 plus one or more sleep symptoms. Estimates of the prevalence of OSA in all 2016 participants were 33.8%-45.7% based on physician diagnoses and AHI results, depending on the criteria used. Age, gender, BMI, blood pressure, habitual snoring, neighborhood walkability, actigraphy-measured sleep characteristics, and smoking were concurrently associated with OSA in 2016. Changes in AHI categories from 2016 to 2018 were documented. CONCLUSIONS Low-income African Americans, including women, are a high-risk group for OSA, but remain under-diagnosed and under-treated. The current findings show a high prevalence of OSA in African-American women and are among the first to demonstrate that both individual and neighborhood factors are implicated in OSA prevalence.
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Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, CA 90403, USA
| | | | - Ann Haas
- RAND Corporation, Pittsburgh, PA 15213, USA
| | | | | | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Tiffany L Gary-Webb
- Departments of Epidemiology and Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
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22
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Stearns MA, Nadorff DK. The Moderation of Raising One's Grandchildren on the Relation Between Sleep and Depressive Symptoms. Nat Sci Sleep 2020; 12:615-626. [PMID: 32922105 PMCID: PMC7455767 DOI: 10.2147/nss.s247568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/03/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recent evidence has shown that poor quality sleep is associated with depression, particularly among older individuals. Moreover, given that grandparent caregivers are more likely to report being depressed, it is crucial to identify whether poor sleep quality results in more depressive symptoms when older individuals are also caring for their grandchildren. Thus, the current study examined how caregiving status was associated with the relation between sleep quality and depressive symptoms and the further moderation of gender (ie, 3-way interaction). PARTICIPANTS The sample (N = 459, Mean age = 62.43, 58.40% female) was a subset of individuals recruited in the second wave of the MIDUS project completed in 2009. METHODS Participants answered the Center for Epidemiological Studies Depression Scale (CESD), the Pittsburgh Sleep Quality Index (PSQI), and a question regarding grandparent caregiving status. Moderation analyses were conducted using AMOS 26.0. RESULTS The interaction between global sleep quality and grandparent caregiving status was significant in predicting depressive symptoms, and the interactions examining global sleep quality, subjective sleep quality, sleep latency, sleep duration, sleep efficacy, sleep medication, and daytime dysfunction were significant for males when examined separately, whereby increased sleep difficulties were associated with more depressive symptoms. In all sleep domains, the slope of the interactions was sharper for grandparent caregivers, particularly for males. CONCLUSION Significant differences between interactions for males and females indicated 3-way interactions, such that interactions were significant for males and not females. Therefore, the relation of sleep on depressive symptoms was dependent on grandparent caregivers' status and gender.
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Affiliation(s)
- Melanie A Stearns
- Department of Psychology, Mississippi State University, Mississippi, MS, USA
| | - Danielle K Nadorff
- Department of Psychology, Mississippi State University, Mississippi, MS, USA
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