0360 Neighborhood Disadvantage is Associated with Lower Quality Sleep and More Variability in Weeknight Sleep Duration Among Urban Adolescents

Abstract

Abstract Introduction Differential social and contextual environments may contribute to adolescent sleep disparities. Yet, most prior studies are limited to self-reported sleep data, and the actigraphic studies of sleep are not conducted at a national level, thus limiting the variation in neighborhood contexts. This study examined the association between neighborhood disadvantage and actigraphic assessment of adolescent sleep. Methods Participants (682 adolescents, mean age 15.4 years) were racially/ethnically diverse (44% Black, 26% Hispanic, 17% White, 14% other race/ethnicity), sampled from 20 large US cities in the Fragile Families and Child Wellbeing Study. Neighborhood disadvantage was calculated from American Community Survey 2015 census data using the Standardized Neighborhood Deprivation Index (SNDI), consolidating five variables (proportion of female-headed households, public assistance recipients, households in poverty, adults without high school degrees, and unemployed) into an index. SNDI quartiles 1-3 fell below national averages of SNDI variables (“most disadvantaged”) and were compared to quartile 4 (“least disadvantaged”). Sleep indicators (duration, quality, and timing) were measured over ≥5 nights using wrist-worn accelerometers. Separate multilevel models estimated differences in sleep indicators, adjusting for weekday/weekend and summer/school year. General linear models used within-person standard deviations of sleep indicators (controlling for number of days) to test for associations between neighborhood disadvantage and consistency of weeknight sleep patterns. Models adjusted for individual-level sociodemographic covariates (age, sex, race/ethnicity, household income, caregiver education, and family structure). Results In fully adjusted models, adolescents living in more disadvantaged neighborhoods spent more time awake after falling asleep (4.0 minutes/night, p<0.05), spent greater percentage of nighttime sleep intervals awake (1%, p<.01), and had less consistent sleep duration (11.7% higher standard deviation, p<.05). Sleep duration and timing did not differ across neighborhood groups. Conclusion Living in more disadvantaged neighborhoods is associated with lower quality adolescent sleep; more research is needed to identify causal mechanisms. Support Research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH), award numbers R01HD073352 (PI: Hale), R01HD36916, R01HD39135, and R01 HD40421, and private foundations. The content is the responsibility of the authors and does not represent official NIH views.