Socioeconomic Status, Neighborhood Environment Impact Adolescent Sleep Quality

Socioeconomic status and neighborhood environment are 2 factors that affect adolescent sleep quality, according to study findings published in the journal Sleep Medicine.

Researchers in the United States conducted a cross-sectional research study to evaluate if socioeconomic status and neighborhood environment affected sleep in 323 adolescents from small towns and rural communities across the southeastern United States.

Approximately 62% of the participants were from a larger longitudinal study (Auburn University Sleep Study) with data collected between 2009 and 2012, while the remaining 38% were newly recruited participants with data collected between 2017 and 2019. Approximately 60% of the adolescents were of European American descent and 40% were of African American descent.

The researchers collected relevant sleep data using wearable actigraphs on their nondominant wrists during sleep, including number of minutes slept, sleep efficiency, long wake episodes, and variability in minutes of sleep over a week. Subjective sleep data, such as daytime sleepiness and difficulty waking or getting to sleep, were also assessed using the School Sleep Habits Survey.

Male adolescents demonstrated decreased sleep duration and efficiency and increased long wake episodes than female adolescents. Compared with adolescents of European American descent, adolescents of African American descent demonstrated decreased sleep duration and efficiency as well as increased long wake episodes and problems with sleeping and waking.

They assessed each adolescent’s perceptions of community safety, violence, and crime using the Neighborhood Environment Scale and Community Experiences Questionnaires.

The researchers calculated each adolescent’s income-to-needs ratio (INR) based on reported family income and number of people in each household to determine family socioeconomic status. Around 19% of the families lived in poverty (INR <1), 20% lived near the poverty line (1< INR £2), 20% were lower middle class (2< INR £ 3), 20% were middle class (3< INR £4), and 21% were upper middle class (INR >4).

Higher socioeconomic status based on calculated INRs correlated with improved sleep efficiency and decreased variability in sleep duration as well as fewer sleep/wake problems and long wake episodes. Increased neighborhood safety was also associated with decreased sleep/wake issues and daytime sleepiness. Additionally, using both INR and neighborhood safety together better predicted sleep outcomes.

Compared with adolescents from higher income families who demonstrated that sleep difficulties associated with increased neighborhood risk, adolescents of lower income families demonstrated poorer sleep outcomes regardless of neighborhood circumstances.

“Findings suggest that several dimensions of SES and neighborhood risk may be consequential for adolescents’ sleep,” the researchers noted. “Moderation effects highlight the significance of considering multiple contextual influences towards a better understanding of adolescents’ sleep,” they added.

Study limitations included the cross-sectional study design, use of adolescents’ perceptions on violence in the neighborhood versus actual exposure using objective, official crime reports, lack of assessment of youth from large urban environments, and lack of consideration of parental education and occupation. Additionally, potential errors in data collection may result from using imperfect measures from actigraphs instead of polysomnography.