Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.
Sleep. 2021 Jun 11;44(6). doi: 10.1093/sleep/zsaa276.
Over 75% of US high school students obtain insufficient sleep, placing them at risk for adverse health outcomes. Identification of modifiable determinants of adolescent sleep is needed to inform prevention strategies, yet little is known about the influence of the built environment on adolescent sleep.
In this prospective study, actigraphy was used to assess sleep outcomes among 110 adolescents for 14 days each in eighth and ninth grades: duration (hours/night), onset and offset, and sleeping ≥8 hours. Home addresses were linked to built environment exposures: sound levels, tree canopy cover, street density, intersection density, population density, and housing density. Mixed-effects regression estimated associations of built environment measures with sleep outcomes, adjusting for sex, race, parent education, household income, household size, grade, weeknight status, and neighborhood poverty.
A 1-standard deviation (SD) increase in neighborhood sound was associated with 16 minutes later sleep onset (β = 0.28; 95% confidence interval (CI): 0.06, 0.49) and 25% lower odds of sleeping for ≥8 hours (odds ratio (OR) = 0.75, 95% CI: 0.59, 0.96). A 1-SD increase in neighborhood tree canopy was associated with 18 minutes earlier sleep onset (β = -0.31, 95% CI: -0.49, -0.13) and 10 minutes earlier sleep offset (β= -0.17, 95% CI: -0.28, -0.05). No associations were observed for density-based exposures.
Higher neighborhood sound level was associated with lower odds of sufficient sleep, while higher tree canopy cover was associated with more favorable sleep timing. Neighborhood sound levels and tree canopy cover are potential targets for policies and interventions to support healthier sleep among adolescents.
超过 75%的美国高中生睡眠不足,使他们面临不良健康后果的风险。需要确定青少年睡眠的可改变决定因素,以便为预防策略提供信息,但人们对建筑环境对青少年睡眠的影响知之甚少。
在这项前瞻性研究中,使用活动记录仪在八年级和九年级的 14 天内评估了 110 名青少年的睡眠结果:持续时间(每晚小时数)、开始和结束时间,以及睡眠≥8 小时。家庭住址与建筑环境暴露相关联:声音水平、树冠覆盖率、街道密度、交叉口密度、人口密度和住房密度。混合效应回归估计了建筑环境测量值与睡眠结果之间的关联,调整了性别、种族、父母教育、家庭收入、家庭规模、年级、周内状态和邻里贫困。
邻里噪音每增加一个标准差,睡眠开始时间延迟 16 分钟(β=0.28;95%置信区间(CI):0.06,0.49),睡眠≥8 小时的几率降低 25%(优势比(OR)=0.75,95%CI:0.59,0.96)。邻里树冠每增加一个标准差,睡眠开始时间提前 18 分钟(β=-0.31,95%CI:-0.49,-0.13),睡眠结束时间提前 10 分钟(β=-0.17,95%CI:-0.28,-0.05)。基于密度的暴露没有观察到关联。
较高的邻里噪音水平与较低的充足睡眠时间几率相关,而较高的树冠覆盖率与更有利的睡眠时间相关。邻里噪音水平和树冠覆盖率是支持青少年更健康睡眠的政策和干预措施的潜在目标。