"Sleep disparity" in the population: poor sleep quality is strongly associated with poverty and ethnicity

BMC Public Health

Research Article

Charles C Branas¹  Dawei Xie¹  Michael A Grandner²  Nalaka Gooneratne³  Nirav P Patel⁴ 

[1] Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA;Center for Sleep and Respiratory Neurobiology, University of Pennsylvania, Philadelphia, PA, USA;Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA;Center for Sleep and Respiratory Neurobiology, University of Pennsylvania, Philadelphia, PA, USA;Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA;Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA;Respiratory Specialists and Reading Hospital and Medical Center, Reading, PA, USA;

关键词: Sleep Quality;    Sleep Duration;    Poverty Line;    Poor Sleep;    Poor Sleep Quality;   

DOI  :  10.1186/1471-2458-10-475

 received in 2010-03-15, accepted in 2010-08-11,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundLittle is known about the social determinants of sleep attainment. This study examines the relationship of race/ethnicity, socio-economic status (SES) and other factors upon sleep quality.MethodsA cross-sectional survey of 9,714 randomly selected subjects was used to explore sleep quality obtained by self-report, in relation to socioeconomic factors including poverty, employment status, and education level. The primary outcome was poor sleep quality. Data were collected by the Philadelphia Health Management Corporation.ResultsSignificant differences were observed in the outcome for race/ethnicity (African-American and Latino versus White: unadjusted OR = 1.59, 95% CI 1.24-2.05 and OR = 1.65, 95% CI 1.37-1.98, respectively) and income (below poverty threshold, unadjusted OR = 2.84, 95%CI 2.41-3.35). In multivariable modeling, health indicators significantly influenced sleep quality most prominently in poor individuals. After adjusting for socioeconomic factors (education, employment) and health indicators, the association of income and poor sleep quality diminished, but still persisted in poor Whites while it was no longer significant in poor African-Americans (adjusted OR = 1.95, 95% CI 1.47-2.58 versus OR = 1.16, 95% CI 0.87-1.54, respectively). Post-college education (adjusted OR = 0.47, 95% CI 0.31-0.71) protected against poor sleep.ConclusionsA "sleep disparity" exists in the study population: poor sleep quality is strongly associated with poverty and race. Factors such as employment, education and health status, amongst others, significantly mediated this effect only in poor subjects, suggesting a differential vulnerability to these factors in poor relative to non-poor individuals in the context of sleep quality. Consideration of this could help optimize targeted interventions in certain groups and subsequently reduce the adverse societal effects of poor sleep.

【 授权许可】

Unknown   
© Patel et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.