0617 Association Between Green, Blue, and Open Spaces and Sleep Health in a Black Population: An Analysis of the MetSO Dataset

Abstract

Introduction Blacks have a high burden of poor sleep health outcomes. Environmental determinants, such as green space or open environments, represent an underexplored contributor to sleep burden among Blacks. The extent these environmental factors affect sleep health outcomes within this population has not been adequately explored. To fill this gap in the literature, we investigated associations between environmental factors and sleep outcomes among Blacks in a large urban city. Objectives included (1) examine if zip-code derived open spaces (defined as proportion of open space in residential area,) green spaces (defined as open tree coverage of the ground) and blue spaces (proportion of water space) sleep apnea risk, and insomnia symptoms; (2) Examine if open, blue, and green spaces predict sleep outcomes independent of sex, age, and education level. Methods Our study used data from the Metabolic Syndrome Cohort Study (2009-2014), a studythat examined behavioral intervention methods to improve sleep apnea outcomes among Blacks. Sleep Apnea was assessed with the ARES (apnea risk) scale and insomnia status was collected through self-report (“Do you have difficulty staying/falling asleep or waking up?”) in a subset of 344 participants. Logistic regression analyses were performed to predict the effect green, blue, and open spaces had on sleep outcomes. To account for within zip-code correlation, mixed effects models (unadjusted and adjusted) account for sex, age, and education were considered. Results We found that none of the green, blue, or open space variables predicted sleep outcomes in the unadjusted model. In adjusted models, green space predicted sleep apnea risk scores, (OR=1.03, P<.05), but not insomnia. Conclusion Our study examined the extent which green, blue, and open spaces predicted insomnia and sleep apnea in urban blacks. We found that only green spaces were associated with sleep apnea, and none of our environmental variables predicted insomnia. Given the large amount of literature detailing a complex and multifactorial process on how environment affects sleep outcomes, our findings suggest that the link between urban environments, green spaces, and sleep outcomes may not be as definitive as they seem. Further research should explore the differential effect environment has on diverse populations’ sleep outcomes. Support (If Any) NIH R01HL142066, R01HL095799, RO1MD004113, R01HL152453