Sleep Health最新文献_第10页

Perceptions of sleep and sleep research among African American adults 非裔美国成年人的睡眠认知和睡眠研究。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-07-01 DOI: 10.1016/j.sleh.2025.05.007

Paul Peyrel PhD , Matthew Viverito BA , Danielle Eliser MA , MaKayla Tanksley BSc , Robert L. Newton Jr PhD , Owen T. Carmichael PhD , Kelly G. Baron PhD , Prachi Singh PhD

Objectives

Understanding contributors to poor sleep and effective interventions to improve sleep among African Americans remain lacking due to their under-representation in sleep research. This study aimed to examine this population’s sleep-related perceptions, as well as facilitators, barriers, and willingness to participate in sleep research.

Methods

African American men and women (n = 36, 53.4 ± 14.4 years [mean ± SD]) from the Greater Baton Rouge area were recruited and assigned to a focus group. Five 60- to 90-minute focus group sessions were conducted using a semistructured interview guide. Prompts were related to sleep and sleep research. Each session was recorded, transcribed, and coded for content analysis to capture themes in the discussions.

Results

Thirty participants reported a total sleep time less than or equal to 6 hours most nights of the week. Participants were aware of the importance of sleep for physical and mental health and were interested in improving their sleep. Most participants indicated a willingness to participate in sleep research. Perceived benefits included increased knowledge on how to improve sleep, identification of personal triggers that may contribute to poor sleep, and improvement in quality of life and health. Barriers to sleep research participation included lack of trust, time commitment, study procedures, and inability to change their habits. Conversely, building trust and community presence were seen as facilitators to sleep research studies.

Conclusions

African Americans displayed knowledge related to importance of sleep and its relationship with health outcomes. Despite a long history of mistrust of medical researchers among African Americans, there is an interest in sleep research participation.

目的：由于非洲裔美国人在睡眠研究中的代表性不足，了解导致睡眠不良的原因和有效的干预措施来改善他们的睡眠仍然缺乏。这项研究旨在调查这一人群的睡眠相关观念，以及参与睡眠研究的促进因素、障碍和意愿。方法：从大巴吞鲁日地区招募非裔美国男性和女性（n = 36, 53.4±14.4岁[mean±SD]），并将其分配为焦点组。使用半结构化访谈指南进行了五次60至90分钟的焦点小组会议。提示与睡眠和睡眠研究有关。每次会议都被记录、转录和编码，以便进行内容分析，以捕捉讨论中的主题。结果：30名参与者报告一周中大多数晚上的总睡眠时间少于或等于6小时。参与者意识到睡眠对身心健康的重要性，并对改善睡眠感兴趣。大多数参与者表示愿意参与睡眠研究。可感知的好处包括增加了关于如何改善睡眠的知识，确定了可能导致睡眠不良的个人诱因，以及改善了生活质量和健康状况。参与睡眠研究的障碍包括缺乏信任、时间承诺、研究程序以及无法改变他们的习惯。相反，建立信任和社区存在被视为睡眠研究的促进因素。结论：非裔美国人表现出与睡眠重要性及其与健康结果的关系相关的知识。尽管非洲裔美国人对医学研究人员的不信任由来已久，但他们对参与睡眠研究很感兴趣。

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引用次数: 0

Dreamscapes and sleep science 梦境和睡眠科学。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-08-28 DOI: 10.1016/j.sleh.2025.08.004

Kyran Blau, Meir Kryger MD

引用次数: 0

“No rest for me tonight”: A social-ecological exploration of insomnia in rural Appalachian women “今晚我不休息”：阿巴拉契亚农村妇女失眠的社会生态学探索。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-06-20 DOI: 10.1016/j.sleh.2025.04.009

Mairead E. Moloney PhD , Daniela C. Moga PhD , Michael Grandner PhD , Nancy Schoenberg PhD

Objectives

Insomnia disproportionally affects women and is prevalent among rural Appalachian adults at higher rates than in the general US population. Given the strong, bi-directional relationship between sleep and health, a better understanding of insomnia in this health-disparate population is critical. The present study focused on the sex (females), gender (women), and age group (45+) at highest insomnia risk and explores the social determinants of sleep that contributed to insomnia.

Methods

Semistructured telephone interviews were conducted to understand factors associated with insomnia among rural Appalachian women who self-reported insomnia symptoms ≥3 nights per week for ≥3 months. Interviews were recorded with permission and transcribed. We used a multistage, inductive and deductive coding process aided by NVIVO 12.0 software.

Results

Participants were 46 cisgender women in rural Appalachia who met the criteria for insomnia. The social-ecological model was our interpretative framework. Findings illuminate individual (e.g., rumination, menopause, pain, depression), social (e.g., family roles, grief, caregiving, financial concerns), and societal (e.g., gender norms, technology use) factors that likely contribute to insomnia among middle-aged rural Appalachian women.

Conclusions

Across levels of the social-ecological model, factors of female sex (e.g., menopause) and gendered behaviors, roles, and norms (e.g., caregiving close and extended kin) played a central role in the precipitation and perpetuation of insomnia in this population. Attending to the regional cultural norms of heightened self-sufficiency, domestic work, and inter-generational familial care may aid healthcare providers and policy makers aiming to address insomnia among rural Appalachian women as well as other rural populations.

目的：失眠症对女性的影响不成比例，在阿巴拉契亚农村成年人中普遍存在，其发病率高于美国总人口。考虑到睡眠和健康之间强烈的双向关系，更好地了解这些健康状况不同的人群的失眠是至关重要的。目前的研究集中在失眠风险最高的性别（女性）、性别（女性）和年龄组（45岁以上），并探讨了导致失眠的睡眠的社会决定因素。方法：采用半结构化电话访谈法，对自述失眠症状≥每周3晚、持续≥3个月的阿巴拉契亚农村妇女进行调查，了解与失眠相关的因素。采访是在获得许可的情况下录制并抄写的。在NVIVO 12.0软件的辅助下，我们采用了多阶段的归纳和演绎编码过程。结果：参与者为46名阿巴拉契亚农村符合失眠标准的顺性别妇女。社会生态模型是我们的解释框架。研究结果阐明了可能导致阿巴拉契亚中年农村妇女失眠的个人因素（如沉思、更年期、疼痛、抑郁）、社会因素（如家庭角色、悲伤、照顾、经济问题）和社会因素（如性别规范、技术使用）。结论：在社会生态模型的各个层面上，女性性别因素（如更年期）和性别行为、角色和规范（如照顾近亲和远亲）在该人群中失眠的形成和延续中发挥了核心作用。关注提高自给自足、家务劳动和代际家庭护理的地区文化规范，可能有助于医疗保健提供者和政策制定者解决阿巴拉契亚农村妇女以及其他农村人口的失眠问题。

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引用次数: 0

Screen use and sleep health in children, adolescents, and adults: National Sleep Foundation consensus considerations and practical suggestions 儿童、青少年和成人的屏幕使用和睡眠健康：国家睡眠基金会的共识考虑和实际建议。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-07-22 DOI: 10.1016/j.sleh.2025.05.002

Michael A. Grandner PhD, MTR , Joseph M. Dzierzewski PhD, David Gozal MD, John G. Lopos, Alysa N. Miller PhD, Susan Redline MD, MPH

引用次数: 0

Association between insomnia symptoms and chronotype—A systematic review and meta-analysis 失眠症状与a型睡眠时间型的关系

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-08-07 DOI: 10.1016/j.sleh.2025.06.011

Yuqing Zhao MA , Haizhen Chen BSc , Torbjörn Åkerstedt PhD , Zefan Zhang MSc , Shuai Wang MD, PhD , Xiao Tan PhD

Objectives

This meta-analysis aimed to examine the association between chronotype and insomnia.

Methods

A systematic search of PubMed, Embase, and the Cochrane Library was conducted to identify prospective and cross-sectional studies published before July 2023. Sixteen studies involving 27,789 participants were included. Chronotype was assessed using the Morningness-Eveningness Questionnaire. Odds ratios with 95% confidence intervals were calculated for dichotomous outcomes, and mean differences with 95% confidence intervals were used for continuous outcomes. Random-effects models were applied in the presence of moderate-to-high heterogeneity. Sensitivity and subgroup analyses were performed to assess robustness and consistency.

Results

Compared with morning types, evening chronotypes had a significantly higher risk of insomnia (odds ratio, 3.47; 95% confidence interval, 2.50-4.83; P<.00001) and higher ISI scores (mean difference, 3.00; 95% confidence interval, 1.70-4.30; P<.00001). Intermediate chronotypes also showed elevated risk (odds ratio, 1.61; 95% confidence interval, 1.24-2.09; P = .0004) and moderately higher ISI scores (mean difference, 1.55; 95% confidence interval, 0.47-2.63; P = .005) compared with morning types.

Conclusion

Individuals with an evening chronotype were more likely to report insomnia symptoms compared with those with morning or intermediate chronotypes. Intermediate chronotypes tended to have a moderate association, while morning types showed the lowest likelihood of reporting insomnia symptoms. These findings highlight the importance of considering chronotype in the assessment and management of insomnia.

目的：本荟萃分析旨在研究睡眠类型与失眠之间的关系。方法：对PubMed、Embase和Cochrane图书馆进行系统检索，以确定2023年7月之前发表的前瞻性和横断面研究。纳入了16项研究，涉及27,789名参与者。时间类型评估使用晨醒性问卷。对于二分类结果计算具有95%置信区间的优势比，对于连续结果使用具有95%置信区间的平均差异。在存在中高异质性的情况下应用随机效应模型。进行敏感性和亚组分析以评估稳健性和一致性。结果：与早起型的人相比，晚睡型的人失眠的风险明显更高(优势比为3.47；95%置信区间为2.50-4.83；结论：与早晨或中间时间型的人相比，夜晚时间型的人更有可能报告失眠症状。中等时间类型的人往往有中等程度的关联，而早起类型的人报告失眠症状的可能性最低。这些发现强调了在失眠的评估和管理中考虑睡眠类型的重要性。

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引用次数: 0

Racial and ethnic variations in sleep outcomes following a Brief Sleep Intervention in United States Air Force Technical Training students 美国空军技术训练学生短暂睡眠干预后睡眠结果的种族差异。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-06-10 DOI: 10.1016/j.sleh.2025.04.007

Faith S. Luyster PhD , Xin-Qun Wang MS , Chase A. Aycock PsyD , Rosemary Estevez Burns PhD , Trevin Glasgow PhD , Jennifer P. Halbert MSPH, CPH , Kara P. Wiseman MPH, PhD , Gerald Wayne Talcott PhD , Jordan Ellis PhD

Objective

Racial and ethnic minorities in civilian and military populations report worse sleep health than non-Hispanic Whites. A group-based, single-session Brief Sleep Intervention for United States Air Force trainees improved sleep outcomes, yet the effects across racial and ethnic groups remain unclear. This secondary analysis examined racial and ethnic differences in sleep outcomes and behavior change engagement following the Brief Sleep Intervention.

Methods

The sample included 321 United States Air Force Technical Training students (mean age 20.9 ± 3.6; 81.9% men; 51.7% non-Hispanic Whites; 24.3% Hispanic; 23.4% non-Hispanic People of Color). Weekday sleep duration and quality along with weekend catch-up sleep duration were assessed at baseline and 2-week follow-up. At follow-up, Brief Sleep Intervention participants reported engagement in a self-selected behavior change action. Propensity score--adjusted logistic and linear regression models were used.

Results

Among Hispanic students, those in the Brief Sleep Intervention group were more likely to achieve a weekday sleep duration of ≥6 hours and report good/very good weekend sleep compared with those in the active control group. Within the Brief Sleep Intervention group, as compared with non-Hispanic Whites and non-Hispanic People of Color students, Hispanic students showed higher rates of weekday sleep duration ≥6 hours, good/very good weekday sleep quality, and engagement in a behavior change action than non-Hispanic Whites.

Conclusions

Hispanic students who received the Brief Sleep Intervention demonstrated superior sleep outcomes and higher behavior change engagement compared with students from other racial and ethnic groups. Further research should investigate factors driving these differences and identify aspects of the Brief Sleep Intervention that contribute to its effectiveness for Hispanic United States Air Force trainees.

目的：平民和军人中的少数种族和族裔报告睡眠健康状况比非西班牙裔白人差。针对美国空军受训者的一项以小组为基础的单次短暂睡眠干预改善了睡眠结果，但对种族和民族群体的影响仍不清楚。这一次要分析考察了在短暂睡眠干预后，种族和民族在睡眠结果和行为改变参与方面的差异。方法：选取321名美国空军技术训练学员(平均年龄20.9±3.6岁；男性81.9%;非西班牙裔白人占51.7%；24.3%的西班牙裔;23.4%的非西班牙裔有色人种)。在基线和2周随访时评估工作日睡眠时间和质量以及周末补觉时间。在随访中，短暂睡眠干预的参与者报告了自己选择的行为改变行动。采用倾向得分调整后的逻辑回归模型和线性回归模型。结果：在西班牙裔学生中，与积极对照组相比，短暂睡眠干预组的学生更有可能实现工作日睡眠时间≥6小时，并报告良好/非常良好的周末睡眠。在短暂睡眠干预组中，与非西班牙裔白人和非西班牙裔有色人种学生相比，西班牙裔学生在工作日睡眠时间≥6小时、良好/非常良好的工作日睡眠质量和参与行为改变行动方面的比例高于非西班牙裔白人。结论：与其他种族和民族的学生相比，接受短暂睡眠干预的西班牙裔学生表现出更好的睡眠结果和更高的行为改变参与。进一步的研究应调查导致这些差异的因素，并确定短暂睡眠干预对西班牙裔美国空军学员有效的方面。

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引用次数: 0

College students’ socioeconomic background and sleep during the first year of college 大学生的社会经济背景与大学第一年的睡眠。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-07-24 DOI: 10.1016/j.sleh.2025.06.002

Sarah Rocha MA , Xochitl Arlene Smola MA, Ava Trimble MA, Luca Mc Donnell BA, Craig K. Enders PhD, Andrew J. Fuligni PhD

Objective

Sleep problems can hinder adjustment to college, but limited work has evaluated whether students’ socioeconomic background is related to changes in sleep across the first year of college. The goal of the present study was to evaluate whether college-related financial stress, college generational status, and subjective social status were associated with differences in sleep across the first year of college.

Methods

A total of n = 216 first-year college students (M_Age = 18.1) at a public university were recruited for sleep quality assessment via the Pittsburgh Sleep Quality Index during the fall, winter, and spring academic quarters, and a subsample (n = 198) of these students participated in 14 days of sleep diary assessment at the beginning and end of the academic year.

Results

Greater financial stress was significantly associated with worse sleep quality, more variable daily sleep duration, and greater difficulty waking up in the mornings. First-generation status was associated with poorer quality and more variable sleep, and worse subjective social status was linked to poor-quality sleep and greater difficulty awakening, but several of these associations were reduced after adjusting for ethnicity and gender. Mean-level socioeconomic indices did not interact with time, suggesting that between-person differences in sleep were consistent across the first academic year. Within-person increases in financial stress and subjective social status were associated with lower sleep variability.

Conclusion

The study findings reveal significant socioeconomic-related differences in first-year college students’ sleep behavior. Intervention efforts to address college students’ sleep health may benefit from connecting low-socioeconomic status students with resources to facilitate adjustment to college.

目的：睡眠问题可能会阻碍大学生活的适应，但有限的工作已经评估了学生的社会经济背景是否与大学第一年的睡眠变化有关。本研究的目的是评估大学相关的经济压力、大学代际地位和主观社会地位是否与大学第一年的睡眠差异有关。方法：选取一所公立大学一年级学生，共n = 216名（MAge = 18.1），于秋季、冬季和春季三个学期采用匹兹堡睡眠质量指数（Pittsburgh sleep quality Index）对其进行睡眠质量评估，其中一子样本（n = 198）分别于学年开始和结束时进行为期14天的睡眠日记评估。结果：更大的经济压力与更差的睡眠质量、更多变的日常睡眠时间和更大的早晨醒来困难显著相关。第一代的社会地位与较差的睡眠质量和更多变的睡眠有关，而较差的主观社会地位与较差的睡眠质量和更大的觉醒困难有关，但在调整种族和性别后，这些联系中的一些减少了。平均水平的社会经济指数与时间没有相互作用，这表明在第一学年，人与人之间的睡眠差异是一致的。个人经济压力和主观社会地位的增加与较低的睡眠变异性有关。结论：研究结果显示，大一学生的睡眠行为存在显著的社会经济差异。解决大学生睡眠健康问题的干预措施可以通过将低社会经济地位的学生与资源联系起来，以促进他们适应大学生活。

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引用次数: 0

Data-driven approach to understand associations between dietary patterns, sleep problems, and mental health in adolescents 以数据为导向的方法，了解青少年饮食模式、睡眠问题和心理健康之间的关系。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-06-21 DOI: 10.1016/j.sleh.2025.05.001

Yihong Zhao PhD , Xuewei Han MS , Sarah W. Feldstein Ewing PhD , Marie-Pierre St-Onge PhD , Martin P. Paulus MD

Objectives

Emerging evidence suggests a role of diet in sleep disturbances and mental health including internalizing (e.g., anxiety, depression) and externalizing (e.g., aggression, impulsivity) problems.

Methods

This study employed a data-driven approach to construct a Sleep-Mental Health-Eating Index and assessed its mediating roles in the relationships between difficulties initiating and maintaining sleep and mental health problems in 11,000 youth aged 9-10 years. Difficulties initiating and maintaining sleep and mental health problems were assessed annually from baseline to Year2, and diet at Year1. The Shapley Additive Explanations analysis was used to derive the eating index.

Results

Six dietary categories emerged as important predictors of our outcomes, with whole grains, green vegetables, and berries linked to lower difficulties initiating and maintaining sleep scores, while sweet pastries, fast food, and butter cream linked to higher difficulties initiating and maintaining sleep. Dietary factors explained 2.24% of difficulties initiating and maintaining sleep variation, surpassing demographics (1.21%). For internalizing behaviors, dietary and demographic contributions were similar (1.86% vs. 1.98%). Demographics were the strongest predictors of externalizing symptoms (3.84%). Higher baseline difficulties initiating and maintaining sleep (beta = −0.026, 95% CI: −0.038, −0.015) and internalizing scores (beta = −0.027, 95% CI: −0.035, −0.019) were associated with worse eating index at Year1. Additionally, the eating index mediated relationships between baseline difficulties initiating and maintaining sleep/internalizing problems and Year2 outcomes. Overall, indirect effects range from 3.2% to 7.0%.

Conclusions

These findings highlight diet’s role in predicting and mediating sleep and mental health outcomes. Healthy foods were associated with fewer sleep difficulties and internalizing problems, while unhealthy foods worsen sleep and behavior problems. Targeting diet may improve interventions addressing adolescent sleep and mental health challenges.

目的：新出现的证据表明饮食在睡眠障碍和心理健康中的作用，包括内化（如焦虑、抑郁）和外化（如攻击、冲动）问题。方法：采用数据驱动的方法构建睡眠-心理健康-饮食指数，并评估其在11,000名9-10岁青少年启动和维持睡眠困难与心理健康问题之间的中介作用。从基线到第2年，每年评估开始和维持睡眠的困难以及心理健康问题，并在第1年评估饮食。沙普利加性解释分析法用于推导饮食指数。结果：六种饮食类别成为我们研究结果的重要预测因素，其中全谷物、绿色蔬菜和浆果与较低的睡眠开始和维持得分有关，而甜点、快餐和白脱奶油与较高的睡眠开始和维持得分有关。饮食因素解释了2.24%的启动和维持睡眠变化的困难，超过了人口统计学（1.21%）。对于内化行为，饮食和人口统计学的贡献相似（1.86% vs. 1.98%）。人口统计学是外化症状的最强预测因子（3.84%）。较高的开始和维持睡眠的基线困难（β = -0.026, 95% CI: -0.038, -0.015）和内化得分（β = -0.027, 95% CI: -0.035, -0.019）与第一年较差的饮食指数相关。此外，饮食指数介导了开始和维持睡眠/内化问题的基线困难与第二年结果之间的关系。总体而言，间接影响从3.2%到7.0%不等。结论：这些发现强调了饮食在预测和调节睡眠和心理健康结果方面的作用。健康的食物与较少的睡眠困难和内在问题有关，而不健康的食物使睡眠和行为问题恶化。以饮食为目标可能会改善针对青少年睡眠和心理健康挑战的干预措施。

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引用次数: 0

The temporal relationship between long sleep duration and poor hand grip strength in older adults: The Yilan study 老年人睡眠时间长与握力差的时间关系：宜兰研究。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-06-16 DOI: 10.1016/j.sleh.2025.04.010

Nai-Wei Hsu MD, MPH, PhD , Po-Jung Pan MD, MS , Hsuan-Ming Tsao MD , Hsueh-Ping Chiang MS , Pesus Chou DrPH , Hsi-Chung Chen MD, PhD

Objectives

Muscle strength is an important subdomain of intrinsic capacity in older adults. Although poor muscle strength is closely correlated with long sleep duration, a causal relationship has not yet been established. This study aimed to examine whether long sleep duration predicted a decrease in hand grip strength or vice versa.

Methods

In this follow-up study involving a community-based fixed cohort, participants included community-dwelling older adults aged ≥65 years residing in Yilan City, Taiwan. Self-reported sleep duration at night was categorized as short (<6 hours), mid-range (6 to <8 hours), and long (≥8 hours). Hand grip strength was measured using a dynamometer, and poor hand grip strength was defined by age- and sex-specific cutoffs based on one standard deviation below the age- and sex-specific means of the data. Two temporal directions of analyses were performed between sleep duration and hand grip strength. First, baseline participants with good hand grip strength were followed-up to examine whether baseline long sleep predicted poor hand grip strength. In contrast, baseline mid-range sleepers were followed-up to examine whether baseline poor hand grip strength predicted long sleep.

Results

A total of 539 individuals, with an average age of 74.5 ± 5.5 years, participated in the study. The average follow-up period was 5.8 ± 1.8 years. Regarding factors predicting a decrease in hand grip strength, after controlling for various confounders, long sleep duration at baseline predicted incident poor hand grip strength at follow-up visits (odds ratio, 2.63; 95% confidence interval, 1.27-5.43). Conversely, poor hand grip strength failed to predict lengthening of sleep duration.

Conclusion

In older adults, long sleep duration preceded a decrease in hand grip strength.

目的：肌力是老年人内在能力的一个重要子域。虽然肌肉力量差与睡眠时间长密切相关，但因果关系尚未确定。这项研究的目的是研究长时间睡眠是否会导致手部握力下降，反之亦然。方法：采用以社区为基础的固定队列随访研究，研究对象为居住在宜兰市的≥65岁的社区老年人。自我报告的夜间睡眠时间被归类为短(结果：共有539人参加了这项研究，平均年龄为74.5±5.5岁。平均随访时间为5.8±1.8年。对于预测手握力下降的因素，在控制了各种混杂因素后，基线时的长睡眠时间预测随访时发生的手握力下降(优势比，2.63；95%置信区间，1.27-5.43)。相反，握力差并不能预测睡眠时间的延长。结论：在老年人中，长时间睡眠导致了手握力下降。

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引用次数: 0

Sleep duration associated with acute care utilization: Revisiting Andersen’s Behavioral Model of Health Services Use 睡眠时间与急性护理利用的关系：重新审视安徒生的卫生服务使用行为模型。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2025-10-01 Epub Date: 2025-08-12 DOI: 10.1016/j.sleh.2025.06.007

Marie-Rachelle Narcisse PhD , Rhoda Moise PhD , Pearl A. McElfish PhD , Holly C. Felix PhD , Tracie Kirkland DNP , Girardin Jean-Louis PhD

Objectives

Andersen’s Behavioral Model of Health Services Use explains healthcare utilization through three key domains—health needs, predisposing characteristics, and enabling resources—that influence whether individuals access medical care. This study examined whether self-reported sleep duration, as a health needs factor, is associated with acute care hospital utilization in the United States.

Methods

We analyzed data from 30,122 civilians ages 18+ from the 2020 National Health Interview Survey. Acute care utilization included past-year emergency room visits and overnight hospitalizations. Zero-inflated negative binomial and multivariable logistic regression models were used to assess associations of health needs, predisposing, and enabling factors with acute care utilization.

Results

Eight in 10 adults had no emergency room visits (81.1%), while 12.3% had one visit, 4.3% had two, 1.1% had three, 1.2% had 4+ visits, and 8.4% experienced overnight hospitalization. Sixty-four percent reported healthy sleep. Very short and long sleep were associated with significantly higher emergency room visit rates, while very short, short, and long sleep were associated with greater odds of overnight hospitalization compared with healthy sleep. Poor or fair health and multiple chronic conditions were also associated with increased acute care use. Predisposing (e.g., ages 18-44, female sex, Black race, and place of birth) and enabling factors (e.g., financial hardship, health insurance) further contributed to greater utilization.

Conclusions

Sleep duration is a significant and underexamined health needs factor in acute care utilization. Improving sleep health may help reduce the frequency of emergency room visits and hospitalizations. Future studies should explore the directionality of these associations and examine other sleep dimensions in relation to acute care utilization.

目的：安徒生的健康服务使用行为模型通过三个关键领域——健康需求、倾向特征和使能资源——来解释医疗保健利用，这些领域影响个人是否获得医疗保健。这项研究调查了自我报告的睡眠时间，作为一个健康需求因素，是否与美国急症护理医院的使用率有关。方法：我们分析了来自2020年全国健康访谈调查的30122名18岁以上平民的数据。急性护理利用包括过去一年的急诊室就诊和过夜住院。使用零膨胀负二项和多变量logistic回归模型来评估健康需求、易感因素和使能因素与急性护理利用的关系。结果：8 / 10的成年人没有急诊室就诊（81.1%），12.3%的人有一次就诊，4.3%的人有两次就诊，1.1%的人有三次就诊，1.2%的人有4次以上就诊，8.4%的人住院过夜。64%的人表示睡眠健康。与健康睡眠相比，睡眠时间过短和过长与更高的急诊室就诊率相关，而睡眠时间过短、过短和过长与更大的过夜住院率相关。较差或一般的健康状况和多种慢性疾病也与急症护理使用的增加有关。易患因素（例如，18-44岁、女性、黑人种族和出生地）和有利因素（例如，经济困难、医疗保险）进一步促进了更高的利用率。结论：睡眠时间是急性护理利用中一个重要但未被充分研究的健康需求因素。改善睡眠健康可能有助于减少急诊室就诊和住院的频率。未来的研究应该探索这些关联的方向性，并检查其他睡眠维度与急性护理利用的关系。

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引用次数: 0