Abstract P519: Sleep as a Cardiometabolic Risk Factor Following Release From Carceral Facilities

Abstract

Background: Approximately 2 million people are incarcerated, and 11 million cycle in and out of U.S. jails and prisons annually. Cardiovascular disease (CVD) morbidity and mortality are higher among people with a history of incarceration, especially in the weeks following release from prison. Sleep is an underexplored factor that may contribute to CVD disparities among people with a history of incarceration. Population-specific risk factors in the social and physical environment may contribute to poor sleep and CVD risk during imprisonment and after release from a carceral facility. Methods: The Sleep Justice study, an ancillary study to an ongoing prospective cohort recruiting individuals with known cardiovascular risk factors within three months of release from incarceration, the Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study, aimed to describe sleep and examine the connections between sleep and CVD risk factor control among people released from a carceral facility. Sleep was assessed using subjective and objective measures. The Pittsburgh Sleep Quality Index (PSQI), the STOP-Bang, and the Brief Index of Sleep Control were used, and wrist-worn actigraphy was used to measure sleep objectively in a subsample of 80 participants. We will examine sleep and its association with CVD in this sample of people recently released from a carceral facility. Results: Most participants were male (92%), non-Hispanic Black (51%) or Hispanic (27%), were incarcerated 2-5 times, and were living in transitional housing (78%) at baseline. All participants had a CVD risk factor as a requirement of the study inclusion criteria: hypertension (78%), hyperlipidemia (47%), obesity (59%), diabetes (29%), and history of CVD (19%). Most reported low (24%) or some control (35%) over their sleep. Participants were at increased risk for sleep apnea, with 47% at moderate risk and 23% at high risk. Most participants reported poor sleep quality (65%) on the PSQI. We conducted logistic regression examining the relationship between sleep and CVD risk and found that poor sleep quality was associated with HTN (p=0.02), even after adjusting for age, race and ethnicity, and gender (AOR 2.44, 95% CI 1.14-5.29). Discussion: Given the disproportionate incarceration of racial and ethnic minoritized groups, the impact of incarceration on sleep health and CVD are areas that urgently need to be examined. This study is the first to examine sleep after release from a carceral facility and highlights the need for interventions targeting sleep health and CVD in this population.