Sleep Quality and Risk for Sleep Apnea in Incarcerated Women

Abstract

Background Little is known about characteristics of women's sleep during incarceration. Objectives The study objectives were to: describe incarcerated women's sleep quality; document incarcerated women's risk for sleep apnea; and identify other factors that contribute to poor sleep quality during incarceration. Methods This cross-sectional descriptive exploratory investigation was conducted in a maximum security women's prison in the United States. Incarcerated women's sleep quality and their risk for sleep apnea was assessed by using the Pittsburgh Sleep Quality Index (PSQI) and the Multivariable Apnea Prediction Score (MAPS), respectively. Results Four hundred thirty-eight incarcerated women participated in this investigation. Results indicate that 72% of the sample met the PSQI criteria for “poor sleepers.” Poor sleepers were significantly more likely to report sleep disturbances, and scored significantly higher on the risk for sleep apnea scale compared to women who did not meet the poor sleep threshold. Approximately 10% of the sample had a probability for sleep apnea higher than .50. Factors that contributed to poor sleep included: (a) “racing thoughts/worry/thinking about things”; (b) environmental noise and other factors; (c) physical health conditions/pain; (d) nightmares and flashbacks; and (e) not taking sleep medication. Discussion Most participants reported poor sleep quality during incarceration. Poor sleep might exacerbate existing health conditions and contribute to the development of new health problems for incarcerated women. Furthermore, poor sleep quality may reduce a woman's ability to fully participate in beneficial prison programming. This investigation provides a first look at how women sleep in prison and offers recommendations for future research.

Changes in sleep pattern and sleep quality during COVID-19 lockdown

“…Earlier studies that have assessed the effect of confinement on sleep have been done in astronauts preparing for Mars mission, incarcerated women, and seafarers. [ 6 7 8 ] However, the results of these studies cannot be extrapolated to home confinement during COVID-19 lockdown as the nature of confinement is different. First, data from the Mars mission simulation involved only six members of different nationalities, limited space for physical activity, active engagement in training, and prolonged confinement, i.e., 520 days.…”

“…[ 6 ] Although the study among incarcerated women had a larger sample size, it cannot be extended to the general population as stressors, and sleep environments were different from those in home confinement. [ 7 ] The third study included seafarers who were on the ship and engaged in a normal routine. Besides that, the study population in these studies did not have responsibilities other than the profession related, had little opportunities for leisure activities and were not anticipating any threat to life.…”

Disparities in Sleep Health and Potential Intervention Models

“…Similarly, shorter sleep duration was associated with lower rated neighborhood trust and helping behavior among adults living in Philadelphia area communities 25. Incarcerated women reported poor sleep quality as measured by Pittsburgh Sleep Quality Index related to both perception of safety and the prison environment (noise, light, and uncomfortable bunks) 26. These differential environments likely contribute to the reported lower sleep quality and opportunity and overall sleep disparities.Beyond neighborhood factors, household and employment factors likely contribute to sleep health disparities.…”

Adaptation of the System for Observing Play and Recreation in Communities (SOPARC) for the Measurement of Physical Activity in Jail Settings

“…This is important as health needs of individuals incarcerated in jail are complex. Individuals incarcerated in jail facilities experience high rates of hypertension [10][11][12], poor sleep quality [13], anxiety and depression [14], and more may experience anxiety-like symptoms from being incarcerated. However, 76% of individuals incarcerated in jail do not use recreation time regularly due to motivational, equipment, and safety factors [3], and physical activity levels during incarceration are unknown.…”