Arber Sara, Bote Marcos, Meadows Robert
Department of Sociology, University of Surrey, Guildford, Surrey GU2 7XH, UK.
Soc Sci Med. 2009 Jan;68(2):281-9. doi: 10.1016/j.socscimed.2008.10.016. Epub 2008 Nov 19.
Sleep is fundamental to health and well-being, yet relatively little research attention has been paid to sleep quality. This paper addresses how socio-economic circumstances and gender are associated with sleep problems. We examine (i) socio-economic status (SES) patterning of reported sleep problems, (ii) whether SES differences in sleep problems can be explained by socio-demographic characteristics, smoking, worries, health and depression, and (iii) gender differences in sleep problems, addressing the relative contribution of SES, smoking, worries, health and depression in explaining these differences. Logistic regression is used to analyse the British Psychiatric Morbidity Survey 2000, which interviewed 8578 men and women aged 16-74. Strong independent associations are found between sleep problems and four measures of SES: household income, educational qualifications, living in rented housing and not being in paid employment. Income differences in sleep problems were no longer significant when health and other characteristics were adjusted. The higher odds of sleep problems among the unemployed and adults with low education remained significant following adjustment. Women reported significantly more sleep problems than men, as did the divorced and widowed compared with married respondents. Gender differences in sleep problems were halved following adjustment for socio-economic characteristics, suggesting that SES inequalities play a major part in accounting for gender differences in sleep problems. Our study casts doubt on the primacy of physiological explanations underlying these gender differences. Since disadvantaged socio-economic characteristics are strongly associated with sleep problems, we conclude that disrupted sleep may be a mechanism through which low SES is linked to poor health.
睡眠对健康和幸福至关重要，但睡眠质量却相对较少受到研究关注。本文探讨社会经济状况和性别如何与睡眠问题相关联。我们研究：（i）报告的睡眠问题的社会经济地位（SES）模式；（ii）睡眠问题中的SES差异是否可由社会人口特征、吸烟、忧虑、健康状况和抑郁来解释；以及（iii）睡眠问题中的性别差异，探讨SES、吸烟、忧虑、健康状况和抑郁在解释这些差异方面的相对作用。运用逻辑回归分析2000年英国精神病发病率调查，该调查访问了8578名年龄在16 - 74岁之间的男性和女性。研究发现睡眠问题与SES的四项指标之间存在强烈的独立关联：家庭收入、教育程度、租住房屋以及未从事有偿工作。在对健康状况和其他特征进行调整后，睡眠问题中的收入差异不再显著。经调整后，失业者和低学历成年人中睡眠问题的较高几率仍然显著。女性报告的睡眠问题明显多于男性，离婚者和丧偶者与已婚受访者相比也是如此。在对社会经济特征进行调整后，睡眠问题中的性别差异减半，这表明SES不平等在解释睡眠问题中的性别差异方面起主要作用。我们的研究对这些性别差异背后生理解释的首要地位提出了质疑。由于处于劣势的社会经济特征与睡眠问题密切相关，我们得出结论，睡眠紊乱可能是低SES与健康不佳相联系的一种机制。
