Neighborhood socioeconomic status, sleep duration, and napping in middle-to-old aged US men and women

Abstract

Study objectives: Earlier studies have linked neighborhood disadvantage with poor sleep outcomes. However, little is known about the association between changes in one's neighborhood over time and night sleep and napping. In over 300000 middle-to-old aged Americans, we examined neighborhood socioeconomic status (SES) and change in neighborhood SES in relation to nocturnal sleep duration and napping.

Methods: Nocturnal sleep duration and daytime napping were self-reported at baseline (1995-1996). Participants also reported baseline residential addresses, which were linked to US censuses. We derived a neighborhood SES index using census variables and calculated the baseline level and change (1990-2000) in neighborhood SES. Multinomial logistic regression was used to estimate the associations between neighborhood SES over time and nocturnal sleep and napping.

Results: Lower baseline neighborhood SES was associated with short sleep, long sleep, and napping. When compared with the highest quintile of neighborhood SES, the lowest was associated with 46% and 72% increase in relative risk (RR) of reporting very short (< 5 hours) sleep, 28% and 19% higher RR of long (≥9 hours) sleep and 95% and 85% increase in long (≥1 hours) nap in men and women, respectively. Moreover, a decrease in neighborhood SES was associated with higher RR of reporting very short sleep in women; while an improvement in neighborhood SES was associated with an increase in RR of long sleep in men.

Conclusions: Neighborhood disadvantage and worsening neighborhood conditions were associated with unhealthy sleep behaviors. These results reinforce a growing literature on the potential importance of neighborhood context for understanding sleep health.

Figure 1.

Multivariate association between baseline (1995–1996) neighborhood SES and (A) sleep duration and (B) napping. Baseline neighborhood SES is measured by average percentile rankings of neighborhood SES index between 1990 and 2000. Models were adjusted for age, race and ethnicity, education, marital status, state of residence and change in neighborhood SES.

Figure 2.

Multivariate association between changes in neighborhood socioeconomic status (1990–2000) and (A) sleep duration and (B) napping. Changes in neighborhood SES is expressed in difference in percentile ranking between 1990 and 2000. Increase in percentile indicates improved neighborhood SES, while decrease in ranking indicates worsened neighborhood SES. Models were adjusted for age, race and ethnicity, education, marital status, state of residence, and baseline neighborhood SES.