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The influence of psychosocial stressors and socioeconomic status on sleep among caregivers of teenagers with asthma, the Puff City study.

Sleep Health 2018 April
OBJECTIVE: Insufficient sleep is common among caregivers and is associated with worse health outcomes; however, the contributors to poor sleep among caregivers are unknown. We investigated the cross-sectional association between socioeconomic status (SES), psychosocial stressors, and sleep among caregivers.

METHODS: Caregivers (n=98) of teenagers with asthma self-reported sleep duration (hours), sleep quality (very good to very bad), education (<high school to college graduate), income ($15,000 to $50,000), and psychosocial stressors (stress, worry, social support, depressive symptoms, nightly awakenings due to caregiving). Logistic and linear regression models were performed to study the association of between SES, psychosocial stressors, and sleep, adjusting for possible confounders.

RESULTS: Caregivers on average were 45.5 years, female (89%), and African American (90%). Average sleep duration was 5.9 hours (standard deviation: 1.5), 72% reported short sleep (<7 hours), and 65% reported "fairly bad or very bad" sleep quality. After adjustment for covariates, caregivers with greater social support had a 44% (95% confidence interval: 0.32, 0.98) lower odds of short sleep duration and slept 20.0 minutes (3.09, 37) longer on average. Greater depressive symptoms were associated with a 26% (1.11, 1.44) higher odds of short sleep and sleeping on average 6.08 minutes (-8.67, -3.49) less at night. SES and other psychosocial stressors were not associated with sleep.

CONCLUSIONS: Caregivers had a high prevalence of short and poor quality sleep. Depressive symptoms were associated with shorter sleep, whereas social support was associated with longer sleep. Identifying factors that mitigate the effect of psychosocial stressors on sleep is warranted.

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