AS226 - Socioeconomic and environmental disparity of sleep disturbance
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Investigator Names and Contact Information
Jiu-Chiuan Chen [ jcchen@unc.edu ]
Abstract
This application responds to the 2003
National Sleep Disorders Research Plan’s call for prospective studies on
health disparity in sleep disorders among vulnerable populations. The proposed work takes advantage of the
high-quality longitudinal data on sleep disturbance of a very
well-characterized cohort in the Women’s Health Initiative (WHI) and addresses
the national sleep research need in an economical and timely manner. Specifically, longitudinal sleep profiles,
including the validated WHI-Insomnia Rating Scale, of more than 161,000
post-menopausal women will be analyzed for their associations with
socioeconomic attributes of residential environment, as aggregated from US-Census based socioeconomic
indicators, and residence-level of exposures to ambient air pollutants (PM10; PM2.5;
ozone), as estimated through validated environmental
modeling of criteria pollutants data recorded in the U.S. EPA’s Aerometric
Information Retrieval System. Potential
modifications of these putative associations by individual’s biophysical
characteristics will be analyzed to identify subpopulations more vulnerable to sleep
disturbance associated with adverse social environment. The proposed investigation will not only
evaluate sleep disturbance as a putative mediator of health disparity related
to adverse socioeconomic and ambient environment, but also provide
impetus to improve the quality of life and reduce the disease burden associated
with sleep disturbance in postmenopausal women.
Specific Aims
The goal of this research project is to investigate the socioeconomic and environmental disparity of sleep disturbance in a large vulnerable population of postmenopausal women. More specifically, we will use extant data from the WHI Clinical Trial (CT) and Observational Study (OS) to investigate associations between longitudinal sleep profiles, socioeconomic characteristics of neighborhoods in which they reside, and residence-specific ambient air pollutant concentrations. The proposed investigation will evaluate sleep disturbance as a putative mediator of health disparity related to adverse social environment, in light of the multifaceted adverse health responses (immune dysfunction, neuroendocrine alteration, metabolic effects, cardiovascular diseases, poor quality of life) to sleep disturbance. The proposed multi-level analyses incorporating both socioeconomic and environmental factors will examine both their relative and joint contributions to the disparity in sleep disturbance as associated with neighborhood deprivation and disproportionate exposures to ambient air pollutants. With the high-quality longitudinal data on sleep measures, including the validated WHI-Insomnia Rating Scale (WHIIRS) and the comprehensive biophysical and psychosocial data from more than 161,000 post-menopausal women, we will leverage the infrastructure established for, data assembled in, and methodologies developed in support of an ongoing, NIEHS-funded ancillary study, The Environmental Epidemiology of Arrhythmogenesis in WHI (EEAWHI, AS#140) to construct U.S. Census-based socioeconomic indicators of residential environment and model ambient air pollutants data for ozone and particulate matter with aerodynamic diameter ≤10 and 2.5 μm (O3;PM10 & PM2.5).
This application addresses the following specific aims:
1. Socioeconomic determinants for social disparity of sleep disturbance
Describe the longitudinal profiles of sleep disturbance in a multi-ethnic population of postmenopausal women. Examine social disparity of sleep disturbance associated with individual (compositional) and neighborhood (contextual) socioeconomic characteristics.
2. Environmental determinants for social disparity of sleep disturbance
Describe the spatial variability in the frequency of sleep disturbance in a geographically-diverse population of postmenopausal women. Examine how geographical heterogeneity in sleep disturbance is associated with exposure to ambient air pollutants.
3. Population susceptibility to adverse social environment
Investigate the population variability in the associations of sleep disturbance with socioeconomic characteristic of residential neighborhood and residence-levels of exposure to ambient air pollution. Identify susceptible subgroups as characterized by individual socioeconomic status and biophysical attributes.
