The association of neighborhood characteristics with sleep duration and daytime sleepiness

Abstract

Background Neighborhood characteristics have been linked to health outcomes. Various mechanisms link neighborhoods and health outcomes; sleep patterns may be 1 contributor; however, little is known about the social determinants of disordered sleep. We examined the association of neighborhood characteristics with sleep duration and daytime sleepiness. Methods Participants (n = 801) enrolled as pairs (55 without pair), from 10 churches in the Stroke Health and Risk Education project; 760 were included for analysis (41 withdrew). Sleep duration (hours of sleep at night) and daytime sleepiness (adaptation of Berlin questionnaire; range, 0–3 [more daytime sleepiness]) were self-reported. Neighborhood characteristics included disadvantage, per capita violent crime (census tract level), and safety (self-reported and individual level). We fit generalized linear mixed models and multinomial and binomial logistic regression models to examine the associations between neighborhood characteristics and sleep outcomes while accounting for the clustering within churches and pairs, before and after adjustment for self-reported confounders (age, gender, income, education, body mass index, depressive symptoms, hypertension, and diabetes). Results The mean hours of sleep duration is 6.7 ± 1.2, and the mean daytime sleepiness is 0.8 ± 0.9. Neighborhood characteristics were not associated with sleep duration. Higher perceived neighborhood safety was associated with an 18.4% lower odds of daytime sleepiness in the unadjusted model (odds ratio, 0.82 [95% confidence interval, 0.69–0.96]). The association was attenuated in the fully adjusted model. Neighborhood disadvantage and violent crime were related to lower daytime sleepiness; however, associations were not statistically significant. Conclusion Self-reported neighborhood safety was associated with lower daytime sleepiness. Future exploration of the pathways linking neighborhood characteristics and sleep is warranted.

Neighborhood Factors as Predictors of Poor Sleep in the Sueño Ancillary Study of the Hispanic Community Health Study/Study of Latinos

“…These findings are consistent with previous studies that reported an association between short sleep duration and low neighborhood safety. [10][11][12][13][14][15][20][21][22] These prior studies however, relied on self-reported sleep duration, raising concern that the associations might reflect known systematic biases in the accuracy of self-report, rather than an actual effect on sleep per se. Our results demonstrate that the perception that one lives in an unsafe neighborhood is associated with an objective measure of short sleep.…”

“…11,[15][16][17][18][19] However, a major limitation of the existing literature linking adverse neighborhood features such as crime and violence with sleep has been the reliance on unvalidated measures of sleep. [10][11][12][13][14][20][21][22] While studies using actigraphy have evaluated the relationship between sleep and noise, these studies have been limited by small sample size, in-laboratory testing or low levels of noise that may limit generalizability of findings. 23,24 Our goal was to evaluate the relationship between neighborhood environment and validated measures of sleep in a large cohort of US Hispanics/Latinos, the largest racial/ethnic minority group in the United States and a group with a high prevalence of cardiovascular disease risk factors such as diabetes, obesity, and hypertension.…”

Racial disparities in sleep: the role of neighborhood disadvantage

“…Recent literature on neighborhoods and sleep has shown that self-reports of neighborhood safety and quality are associated with several sleep outcomes, including duration (DeSantis et al, 2013), efficiency (Bagley, Tu, Buckhalt, & El-Sheikh, 2016), daytime sleepiness (Johnson, Brown, Morgenstern, Meurer, & Lisabeth, 2015), and overall sleep quality (Hale et al, 2013; Hill et al, 2016). However, very few studies have considered objective measures of neighborhood disadvantage.…”

Is the association between neighborhood characteristics and sleep quality mediated by psychological distress? An analysis of perceived and objective measures of 2 Pittsburgh neighborhoods

“…Because of its influence on metabolic and cardiovascular processes (12) and links to depressive symptoms and suicide (13, 14), sleep could also serve as an important, understudied mechanism through which neighborhood contexts influence poorer physical and mental health (15–18). …”