Food Insecurity and Housing Insecurity Associated with Decreased Sleep Regularity in Adolescents.

OBJECTIVE: While disparities in adolescent sleep health are well-recognized, few studies focus on sleep regularity, a sleep parameter associated with negative physical and mental health consequences. This study aimed to evaluate the association between socio-contextual factors and sleep regularity in healthy adolescents recruited from primary care. METHODS: Data were derived from the baseline assessment for a pilot clinical trial that investigated a digital sleep intervention for teens aged 12-14. Socio-contextual factors included: cut-off utilities, food insecurity, housing insecurity, neighborhood social cohesion, amenities, and perceived safety. The primary outcome of interest was actigraphy-measured sleep regularity quantified by the sleep regularity index (SRI; range 0-100; score = 100 indicates max regularity). Multivariable linear regression, adjusted for sex and age, was performed to examine the relationships between socio-contextual measures and sleep regularity. RESULTS: Sample included 54 youth (mean age 12.94, 44.44% sex assigned female at birth). In the multivariable models, food and housing insecurity were significantly associated with decreased sleep regularity including worry that food would run out (β = -9.23, 95% CI: -13.62 to -4.84, P < 0.001), food running out (β = -10.56, 95% CI: -15.12 to -5.99, P < 0.001), and housing insecurity (β = -17.04, 95% CI: -31.26 to -2.82, P < 0.05). No other significant associations were found. DISCUSSION: Among healthy adolescents recruited from primary care, those living in food or housing insecure households experienced decreased sleep regularity. Further understanding the interplay between socio-contextual factors and sleep is necessary to inform interventions and anticipatory guidance via clinical guidelines for health care providers.

Duke Scholars

Author Naomi Nichele Duke Pediatrics, General Pediatrics and Adolescent Health