Exterior housing conditions are associated with objective measures of poor sleep among low-income older adults with disabilities

Safiyyah M Okoye; Adam P Spira; Nancy A Perrin; Jennifer A Schrack; Hae-Ra Han; Sarah Wanigatunga; Casandra Nyhuis; Sarah L Szanton

doi:10.1016/j.sleh.2021.09.002

Exterior housing conditions are associated with objective measures of poor sleep among low-income older adults with disabilities

Sleep Health. 2021 Dec;7(6):731-734. doi: 10.1016/j.sleh.2021.09.002. Epub 2021 Oct 8.

Authors

Safiyyah M Okoye¹, Adam P Spira², Nancy A Perrin³, Jennifer A Schrack⁴, Hae-Ra Han⁵, Sarah Wanigatunga⁶, Casandra Nyhuis⁶, Sarah L Szanton⁷

Affiliations

¹ Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA. Electronic address: sokoye1@jhmi.edu.
² Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
³ Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
⁴ Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁵ Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁶ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁷ Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA.

Abstract

Objective: To examine the association of housing and neighborhood conditions with sleep among disadvantaged older adults.

Methods: We used data from 136 low-income, predominantly Black older adults with disabilities. Predictors were indices of: interior housing conditions (eg, pests, tripping hazards); exterior housing conditions (eg, broken windows); and neighborhood disorder (eg, litter, vacant buildings). Outcomes were actigraphic total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE).

Results: In models adjusted for age, sex, education, living arrangement, comorbidities, and physical performance, each additional exterior housing problem was associated with 20.9-minutes less TST (95% confidence interval [CI]: -39.2, -2.6), 8.6-minutes more WASO (95% CI: 0.7, 16.5), and 2.3% lower SE (95% CI: -4.2, -0.4). The associations of interior housing conditions and neighborhood disorder with the sleep parameters were of smaller magnitude and not statistically significant.

Conclusions: Future studies should examine the effects of housing repair on sleep health.

Keywords: African American; actigraphy; environment; housing; neighborhood; older adults.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Actigraphy
Aged
Disabled Persons*
Housing Quality
Humans
Sleep
Sleep Initiation and Maintenance Disorders*

Abstract

Publication types

MeSH terms

Grants and funding