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. 2019 Apr;5(2):113-127.
doi: 10.1016/j.sleh.2018.11.002. Epub 2019 Jan 24.

Material hardship and sleep: results from the Michigan Recession and Recovery Study

Lucie Kalousová  1 , Brian Xiao  2 , Sarah A Burgard  2
Affiliations

Material hardship and sleep: results from the Michigan Recession and Recovery Study

Lucie Kalousová et al. Sleep Health. 2019 Apr.

Abstract

Objective: Sleep is unequally distributed in the US population. People with low socioeconomic status report worse quality and shorter sleep than people with high socioeconomic status. Past research hypothesized that a potential reason for this link could be exposure to material hardship. This study examines the associations between several material hardships and sleep outcomes.

Methods: We use population-representative cross-sectional data (n = 730) from the Michigan Recession and Recovery Study collected in 2013 and examine the associations between 6 indicators of material hardship (employment instability, financial problems, housing instability, food insecurity, forgone medical care, and the total number of material hardships reported) and 3 sleep outcomes (short sleep, sleep problems, and nonrestorative sleep). We build multivariable logistic regression models controlling for respondents' characteristics and light pollution near their residence.

Results: In unadjusted models, all material hardships were associated with negative sleep outcomes. In adjusted models, forgone medical care was a statistically significant predictor of nonrestorative sleep (average marginal effect 0.16), as was employment instability (average marginal effect 0.12). The probability of sleep problems and nonrestorative sleep increased with a greater number of hardships overall (average marginal effects of .02 and .05, respectively). We found marginally statistically significant positive associations between food insecurity and short sleep and sleep problems.

Conclusions: This study finds that, except when considering foregone medical care, employment instability, and total count of material hardships, associations between material hardship and negative sleep outcomes are not statistically significant after adjusting for a robust set of sociodemographic and health characteristics.

Keywords: Disparities; Material hardship; Population survey; SES.

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