Division of Sleep and Circadian Disorders, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.
Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
Am J Epidemiol. 2018 May 1;187(5):941-950. doi: 10.1093/aje/kwx302.
Although dense neighborhood built environments support increased physical activity and lower obesity, these features may also disturb sleep. Therefore, we sought to understand the association between the built environment and objectively measured sleep. From 2010 to 2013, we analyzed data from examination 5 of the Multi-Ethnic Study of Atherosclerosis, a diverse population from 6 US cities. We fit multilevel models that assessed the association between the built environment (Street Smart Walk Score, social engagement destinations, street intersections, and population density) and sleep duration or efficiency from 1-week wrist actigraphy in 1,889 individuals. After adjustment for covariates, a 1-standard-deviation increase in Street Smart Walk Score was associated with 23% higher odds of short sleep duration (≤6 hours; odds ratio = 1.2, 95% confidence interval: 1.0, 1.4), as well as shorter average sleep duration (mean difference = -8.1 minutes, 95% confidence interval: -12.1, -4.2). Results were consistent across other built environment measures. Associations were attenuated after adjustment for survey-based measure of neighborhood noise. Dense neighborhood development may have multiple health consequence. In promoting denser neighborhoods to increase walkability, it is important to also implement strategies that reduce the adverse impacts of this development on sleep, such as noise reductions efforts.
尽管密集的邻里建成环境支持增加身体活动和降低肥胖率,但这些特征也可能干扰睡眠。因此,我们试图了解建成环境与客观测量睡眠之间的关联。2010 年至 2013 年,我们分析了来自美国 6 个城市的多种族动脉粥样硬化研究(Multi-Ethnic Study of Atherosclerosis)第五次检查的数据。我们拟合了多层次模型,评估了建成环境(Street Smart Walk Score、社交活动目的地、街道交叉口和人口密度)与 1889 个人为期一周的腕部活动记录仪测量的睡眠持续时间或效率之间的关系。在调整协变量后,Street Smart Walk Score 每增加一个标准差,与短睡眠时间(≤6 小时;优势比=1.2,95%置信区间:1.0,1.4)的几率增加 23%相关,同时平均睡眠时间也较短(平均差异=-8.1 分钟,95%置信区间:-12.1,-4.2)。其他建成环境测量指标的结果也是一致的。在调整基于调查的邻里噪声测量值后,相关性减弱。密集的邻里发展可能会产生多种健康后果。在促进更密集的邻里发展以提高步行便利性的同时,重要的是还要实施减少这种发展对睡眠产生不利影响的策略,例如减少噪音的努力。