Geographic variations in sleep duration: a multilevel analysis from the Boston Area Community Health (BACH) Survey.

Abstract:

BACKGROUND:Sleep plays an important role in health and varies by social determinants. Little is known, however, about geographic variations in sleep and the role of individual-level and neighbourhood-level factors. METHODS:We used a multilevel modelling approach to quantify neighbourhood variation in self-reported sleep duration (very short <5 h; short 5-6.9 h; normative 7-8.9 h; long ≥9 h) among 3591 participants of the Boston Area Community Health Survey. We determined whether geographic variations persisted with control for individual-level demographic, socioeconomic status (SES) and lifestyle factors. We then determined the role of neighbourhood SES (nSES) in geographic variations. Additional models considered individual health factors. RESULTS:Between neighbourhood differences accounted for a substantial portion of total variability in sleep duration. Neighbourhood variation persisted with control for demographics, SES and lifestyle factors. These characteristics accounted for a portion (6-20%) of between-neighbourhood variance in very short, short and long sleep, while nSES accounted for the majority of the remaining between-neighbourhood variances. Low and medium nSES were associated with very short and short sleep (eg, very short sleep OR=2.08; 95% CI 1.38 to 3.14 for low vs high nSES), but not long sleep. Further inclusion of health factors did not appreciably increase the amount of between-neighbourhood variance explained nor did it alter associations. CONCLUSIONS:Sleep duration varied by neighbourhood in a diverse urban setting in the northeastern USA. Individual-level demographics, SES and lifestyle factors explained some geographic variability, while nSES explained a substantial amount. Mechanisms associated with nSES should be examined in future studies to help understand and reduce geographic variations in sleep.

authors

Fang SC,Subramanian SV,Piccolo R,Yang M,Yaggi HK,Bliwise DL,Araujo AB

doi

10.1136/jech-2013-203256

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

63-9

issue

1

eissn

0143-005X

issn

1470-2738

pii

jech-2013-203256

journal_volume

69

pub_type

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