Knutson KL.Sociodemographic and cultural determinants of sleep deficiency: implications for cardiometabolic disease risk. Soc Sci Med 79:7-15

Section of Pulmonary & Critical Care, Department of Medicine, University of Chicago, 5841 S Maryland Ave., MC6076, Chicago, IL 60637, USA.
Social Science [?] Medicine (Impact Factor: 2.89). 05/2012; 79(1). DOI: 10.1016/j.socscimed.2012.05.002
Source: PubMed


Sleep is a biological imperative associated with cardiometabolic disease risk. As such, a thorough discussion of the sociocultural and demographic determinants of sleep is warranted, if not overdue. This paper begins with a brief review of the laboratory and epidemiologic evidence linking sleep deficiency, which includes insufficient sleep and poor sleep quality, with increased risk of chronic cardiometabolic diseases such as obesity, diabetes and hypertension. Identification of the determinants of sleep deficiency is the critical next step to understanding the role sleep plays in human variation in health and disease. Therefore, the majority of this paper describes the different biopsychosocial determinants of sleep, including age, gender, psychosocial factors (depression, stress and loneliness), socioeconomic position and race/ethnicity. In addition, because sleep duration is partly determined by behavior, it will be shaped by cultural values, beliefs and practices. Therefore, possible cultural differences that may impact sleep are discussed. If certain cultural, ethnic or social groups are more likely to experience sleep deficiency, then these differences in sleep could increase their risk of cardiometabolic diseases. Furthermore, if the mechanisms underlying the increased risk of sleep deficiency in certain populations can be identified, interventions could be developed to target these mechanisms, reduce sleep differences and potentially reduce cardiometabolic disease risk.

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    • "" Although the BRFSS sample available for analysis included 451,072 participants, after the exclusion of missing data on county codes, pregnant women, and covariates, the final sample used in the present analysis consisted of 245,531 participants. Guided by the literature examining socio-demographic determinants of sleep patterns (Knutson, 2013), covariates in our analysis included age as a continuous variable, and categorical variables for gender, employment status, race/ ethnicity (Black, White, Asian, Hispanic), level of education, number of children, smoking status, alcohol use, body mass index, asthma status, general health status, income level, disability status, physical activity and emotional support. "
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    ABSTRACT: Abstract Background Exposure to the natural environment may improve health behaviors and mental health outcomes such as increased levels of physical activity and lower levels of depression associated with sleep quality. Little is known about the relationship between insufficient sleep and the natural environment. Purpose To determine whether exposure to attributes of the natural environment (e.g., greenspace) attenuates the likelihood of reporting insufficient sleep among US adults. Methods Multiple logistic regression models were used to explore the association between self-reported days of insufficient sleep (in the past 30 days) and access to the natural environment in a multi-ethnic, nationally representative sample (n = 255,171) of US adults ≥ 18 years of age enrolled in the 2010 Behavioral Risk Factor Surveillance System. Results Using 1-to-6 days of insufficient sleep as the referent group for all analyses, lower odds of exposure to natural amenities were observed for individuals reporting 21-to-29 days (OR = 0.843, 95% confidence interval (CI) = 0.747, 0.951) of insufficient sleep. In stratified analyses, statistically significant lower odds of exposure to natural amenities were found among men reporting 7-to-13-days (OR = 0.911, 95% CI = 0.857, 0.968), 21-to-29-days (OR = 0.838, 95% CI = 0.759, 0.924), and 30-days (OR = 0.860, 95% CI = 0.784, 0.943) of insufficient sleep. Greenspace access was also protective against insufficient sleep for men and individuals aged 65 +. Conclusions In a representative sample of US adults, access to the natural environment attenuated the likelihood of reporting insufficient sleep, particularly among men. Additional studies are needed to examine the impact of natural environment exposure on sleep insufficiency across various socio-demographic groups.
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    • "In many populations, women are more likely to report sleep complaints than men (Haseli-Mashhadi et al., 2009; Stranges et al., 2012; Hsu et al., 2013). Yet it is unclear whether biological differences between the sexes or separate gender roles/expectations cause gender differentials in sleep (Knutson, 2013). SES has an inconsistent relationship with sleep in transitioning countries (Mazzotti et al., 2012; Stranges et al., 2012). "
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    ABSTRACT: Socio-demographic indicators closely relate to sleep in industrialized populations. However we know very little about how such factors impact sleep in populations undergoing industrialization. Within populations transitioning to the global economy, the preliminary evidence has found an inconsistent relationship between socio-demographics and sleep complaints across countries and social strata. Surveys were conducted on a sample of rural Sakha (Yakut) adults (n = 168) during the autumn of 2103 to assess variation in socio-demographics and sleep complaints, including trouble sleeping and daytime sleepiness. Socio-demographic variables included age, gender, socioeconomic measures, and markers of traditional/market-based lifestyle. We tested whether the socio-demographic variables predicted sleep complaints using bivariate analyses and multiple logistic regressions. Trouble sleeping was reported by 18.5% of the participants and excessive daytime sleepiness (EDS) by 17.3%. Trouble sleeping was significantly predicted by older age, female gender, and mixing traditional and market-based lifestyles. EDS was not significantly predicted by any socio-demographic variable. These findings support the few large-scale studies that found inconsistent relationships between measures of socioeconomic status and sleep complaints in transitioning populations. Employing a mix of traditional and market-based lifestyles may leave Sakha in a space of vulnerability, leading to trouble sleeping. Am J Phys Anthropol, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    American Journal of Physical Anthropology 06/2015; 157(4). DOI:10.1002/ajpa.22761 · 2.38 Impact Factor
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    • "c o m / l o c a t e / s o c s c i m e d approach this void in a variety of ways, including reviewing the sociocultural determinants of sleep, exploring sleep and mental health in disadvantaged neighborhoods, comparing and contrasting the perceived link between sleep, dreams, and health in two radically different samples from across the globe, and examining sleep in parts of the world thus far mostly overlooked by previously published sleep research. Knutson (2013) points out that laboratory and epidemiological studies increasingly demonstrate that sleep deficiency, which includes either insufficient sleep, impaired sleep quality or a sleep disorder, is associated with heightened risk of obesity, diabetes and cardiovascular disease. However, improving understanding of the role sleep plays in cardiometabolic disease risk requires detailed analyses of the connections between deficient sleep and risk factors within the social and cultural environment. "
    Social Science [?] Medicine 02/2013; 79:1-6. DOI:10.1016/j.socscimed.2012.11.023 · 2.89 Impact Factor
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