USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA.
Med Care. 2021 Apr 1;59(Suppl 2):S182-S186. doi: 10.1097/MLR.0000000000001410.
The estimated 3.5-million transition age youth (TAY) who experience homelessness in the United States annually are routinely exposed to inadequate sleep environments and other psychosocial risk factors for deficient sleep. Although staying in a shelter versus being unsheltered may facilitate sleep, research suggests that perceived safety wherever one sleeps may be just as important. In this study, which is the first known study to investigate sleep disturbances among TAY experiencing homelessness, we examine associations of sleep disturbances with sheltered status and perceived safety of usual sleep environment.
We surveyed TAY (aged 18-25) experiencing homelessness in Los Angeles, CA about their sleep, psychosocial health, and living situations. Participants (n=103; 60% sheltered) self-reported sleep disturbances using the Patient-Reported Outcomes Measurement Information System Sleep Disturbance short form, while individual items assessed sheltered status and perceived safety where they usually slept. Regression analyses examined associations of sheltered status and perceived sleep environment safety with sleep disturbance, adjusting for age, sex, race, self-rated health, depression symptoms, serious mental illness, high-risk drinking, and severe food insecurity.
Twenty-six percent of participants reported moderate-severe sleep disturbances. Sleep disturbance was not associated with sheltered status, but was positively associated with feeling unsafe in one's sleep environment, depression symptoms, severe food insecurity, and decreased age.
Our findings suggest that sleep disturbances among TAY experiencing homelessness are associated more closely with how safe one feels rather than one's sheltered status. This highlights the importance of providing safe places to live for sheltered and unsheltered TAY.
美国每年约有 350 万处于过渡年龄的青年（TAY）无家可归，他们经常面临睡眠环境不佳和其他睡眠不足的心理社会风险因素。尽管住在庇护所里可能有助于睡眠，但研究表明，无论在哪里睡觉，人们对安全的感知可能同样重要。在这项研究中，我们首次调查了无家可归的 TAY 睡眠障碍，研究了睡眠障碍与有庇护所和通常睡眠环境的安全性感知之间的关联。
我们在加利福尼亚州洛杉矶调查了无家可归的 TAY（年龄在 18-25 岁之间）的睡眠、心理社会健康和生活状况。参与者（n=103；60%有庇护所）使用患者报告的结果测量信息系统睡眠障碍简短形式自我报告睡眠障碍，而个别项目评估了他们通常睡觉的庇护所状态和感知安全。回归分析检查了庇护所状态和感知睡眠环境安全性与睡眠障碍之间的关联，调整了年龄、性别、种族、自我评估健康状况、抑郁症状、严重精神疾病、高风险饮酒和严重食物不安全。
26%的参与者报告有中度至重度睡眠障碍。睡眠障碍与庇护所状态无关，但与睡眠环境不安全、抑郁症状、严重食物不安全和年龄减小有关。
我们的研究结果表明，无家可归的 TAY 睡眠障碍与人们的安全感更为密切相关，而不是他们的庇护所状态。这凸显了为有庇护所和无庇护所的 TAY 提供安全住所的重要性。
