Perceived home sleep environment: associations of household-level factors and in-bed behaviors with actigraphy-based sleep duration and continuity in the Jackson Heart Sleep Study

• Published in: Sleep (New York, N.Y.) N.Y.), 2021-11, Vol.44 (11), p.1
• Main Authors: Johnson, Dayna A, Jackson, Chandra L, Guo, Na, Sofer, Tamar, Laden, Francine, Redline, Susan
• Format: Article
• Language: English
• Subjects: Actigraphy; African Americans; Aged; Analysis; Black or African American; Efficiency; Households; Humans; Polysomnography; Questionnaires; Self Report; Sleep; Sleep disorders; Sleep, Health and Disease; Standard deviation; Video games
• ISSN: 0161-8105; 1550-9109; 1550-9109
• DOI: 10.1093/sleep/zsab163

Abstract Study Objectives In an older African-American sample (n = 231) we tested associations of the household environment and in-bed behaviors with sleep duration, efficiency, and wakefulness after sleep onset (WASO). Methods Older adult participants completed a household-level sleep environment questionnaire, a sleep questionnaire, and underwent 7-day wrist actigraphy for objective measures of sleep. Perceived household environment (self-reported) was evaluated using questions regarding safety, physical comfort, temperature, noise, and light disturbances. In-bed behaviors included watching television, listening to radio/music, use of computer/tablet/phone, playing video games, reading books, and eating. To estimate the combined effect of the components in each domain (perceived household environment and in-bed behaviors), we calculated and standardized a weighted score per sleep outcome (e.g. duration, efficiency, WASO), with a higher score indicating worse conditions. The weights were derived from the coefficients of each component estimated from linear regression models predicting each sleep outcome while adjusting for covariates. Results A standard deviation increase in an adverse household environment score was associated with lower self-reported sleep duration (β = −13.9 min, 95% confidence interval: −26.1, −1.7) and actigraphy-based sleep efficiency (β = −0.7%, −1.4, 0.0). A standard deviation increase in the in-bed behaviors score was associated with lower actigraphy-based sleep duration (β = −9.7 min, −18.0, −1.3), sleep efficiency (β = −1.2%, −1.9, −0.6), and higher WASO (5.3 min, 2.1, 8.6). Conclusion Intervening on the sleep environment, including healthy sleep practices, may improve sleep duration and continuity among African-Americans.