Abstract 28: Social Dimensions of Sleep: An Exploration of Midlife Working-Class Women’s Experiences in Mexico

Abstract

Sleep, one of Life’s Essential 8, is vital to midlife women’s cardiovascular health (CVH). However, achieving healthy sleep is complex. As a first step, it is important to understand the barriers and facilitators to achieve adequate and high-quality sleep among midlife women in a context-specific manner. To comprehensively address this issue, we employed a mixed-methods approach to provide a nuanced understanding of the ecologies and experiences surrounding sleep health among working-class midlife women from Mexico City. First, we utilized existing epidemiologic data on participants to describe sleep and its correlates in a study population (n=120) of women enrolled in a cohort study via objective and subjective standard sleep measures. Then, we used thematic analysis to analyze in-depth ethnographic interview data (n=30) to characterize self-described barriers and facilitators of sleep. Our findings revealed that a substantial proportion of midlife women experienced poor sleep quality, with 53% reporting short sleep duration and 43% experiencing insomnia-related difficulties over seven days. Epidemiologic data suggested poor sleep outcomes were driven by age, type of work/occupation, food insecurity, mental health issues, and diabetes status. Our ethnographic interviews demonstrated that study participants perceived their familial relationships and responsibilities as the prominent barrier to quality sleep, encompassing challenges such as insufficient sleep due to family obligations and sleep disturbances triggered by family-related stressors. Combining these methodological approaches underscored the strong social dimension of sleep, where good sleep hinged on completing household tasks and attending to family needs. In response to sleep deficits, women frequently turned to caffeine consumption and occasional napping as coping mechanisms and described using sleep facilitators, including remedies like teas or other “natural” products. This study highlights the intricate social drivers of sleep, termed the “Sociality of Sleep,” among Mexican midlife women and may demonstrate how sleep recommendations and hygiene principles are likely inadequate in relation to the complex social dynamics of sleep. These insights provide evidence for considering the social context when tailoring recommendations that promote healthy sleep within this demographic. Furthermore, the combined methodology employed in this research may serve as a model for future sleep health studies.