Socioeconomic Risk and Sleep Health Among Young Adults With Type 1 Diabetes

Abstract

Background: While individual socioeconomic risk factors have been examined in relation to various health outcomes in young adults with type 1 diabetes (T1D), the collective impact of significant socioeconomic risk on multiple dimensions of sleep health in this population remains underexplored.

Objective: We sought to examine the association between socioeconomic risk and sleep health dimensions among young adults with T1D.

Methods: Using baseline data from a pilot randomized controlled trial involving 44 young adults (38.6% female, mean age 20.9 years, mean glycated hemoglobin 8.6%), socioeconomic risks were assessed using the Protocol for Responding to and Assessing Patients Assets, Risks, and Experiences framework. Sleep health was evaluated across 6 dimensions: regularity, satisfaction, alertness, timing, efficiency, and duration. We used actigraphy-derived measures of regularity, timing, efficiency, duration, alertness (via the trail-making test), and self-reported satisfaction. Analyses were adjusted for sex, T1D duration, body mass index, and area-level social vulnerability.

Results: Higher socioeconomic risk composite scores were significantly associated with lower sleep satisfaction (β = 0.556, R² = 0.281, P = .001), lower alertness (β = 0.471, R² = 0.292, P = .005), and a lower sleep health composite score (β = -0.368, R² = 0.210, P = .035). No significant associations were identified for sleep regularity, timing, efficiency, or duration.

Conclusions: Higher socioeconomic risk is associated with lower sleep satisfaction, alertness, and multidimensional sleep health among young adults with T1D, independent of covariates. Addressing socioeconomic risk could offer an important target for interventions to improve sleep and health outcomes in this vulnerable population.

Keywords: actigraphy; sleep health; social vulnerability; socioeconomic risk; type 1 diabetes.