Elsevier

Sleep Medicine

Volume 60, August 2019, Pages 165-172
Sleep Medicine

Original Article
Examining social capital in relation to sleep duration, insomnia, and daytime sleepiness

https://doi.org/10.1016/j.sleep.2019.03.019Get rights and content

Highlights

  • Social capital is a strong predictor of health. Yet, little research has examined the relationship between social capital and sleep.

  • We examine the relationship between social capital and sleep parameters, including duration, insomnia, and sleepiness.

  • Our study found an association between social capital and poor sleep health (ie, short sleep duration and insomnia).

Abstract

Objective

Sleep, which plays an important role in health and well-being, is socially patterned such that certain demographic groups have worse sleep health than others. One possible mechanism driving sleep disparities is social capital. The current study examines the association between social capital and self-reported sleep variables (eg, duration, insomnia symptoms, and daytime sleepiness) among a sample of 1007 participants from the Sleep Health and Activity, Diet and Environment Study (SHADES).

Methods

Logistic regressions were used to estimate whether the sleep variables were associated with social capital measures. All models control for age, sex, race/ethnicity (Non-Hispanic White, Black/African-American, Hispanic/Latino, Asian, and multicultural/other), income, and education (less than high school, high school graduate, some college, and college graduate).

Results

Lower likelihood of membership in groups was seen for long sleepers (>9hrs, p-value<0.05) and beliefs that neighbors rarely/never help each other was more likely among short sleepers (5–6hrs, p-value<0.05), relative to 7–8 h sleepers. A decreased sense of belonging was seen among short sleepers (5–6hrs, p-value<0.05). Decreased likelihood of trust was reported by those with moderate-severe insomnia (p-value<0.05). Similarly, neighborhood improvement efforts were less likely among individuals with moderate-to-severe insomnia (p-value<0.05).

Conclusions

Results of our study show that short and long sleep duration, as well as insomnia, were inversely related to measures of social capital, such as group memberships and a sense of neighborhood belonging. Future research may explore the directionality of the relationship between social capital and sleep and perhaps consider future interventions to improve low social capital and/or poor sleep in community samples.

Introduction

Sleep plays an important role in health and well-being [1], [2], [3]. Poor sleep health (eg, sleep duration for less than or equal to 6 h of sleep or poor sleep quality) is associated with poor mental health, anxiety, and depression [4], [5]; higher risk of hypertension and cardiovascular disease [6], [7], [8]; and greater mortality risk [9], [10]. Unfortunately, worse sleep health has been shown to be more common among individuals from low socioeconomic status (SES, low income and education) compared to other groups [11], [12], [13], [14], [15]. This paper contributes to a growing body of research on neighborhood-level characteristics and their relationship to sleep [16], [17], [18], [19]. Specifically, we examine social capital, a social network concept referring to the quality of connections among individuals in a community [20], [21], [22], [23], and its relationship to several dimensions of sleep health, including sleep duration, insomnia, and daytime sleepiness.

Previous research has examined a range of neighborhood factors and their association to sleep. Research has shown high risk for sleep apnea among children living in communities that have low average SES [18], [19]. After adjustment for SES, research has found favorable neighborhood factors (lower neighborhood disorder and higher safety and social cohesion) are associated with higher objectively measured sleep duration [16], and undesirable neighborhood factors (higher neighborhood disorder and lower safety and social cohesion) are associated with shorter sleep duration [17]. Similarly, research has found, controlling for SES, low social cohesion is associated with shorter sleep duration [24]. Moreover, research has found an association between unfavorable neighborhood factors (eg, crime, noise, and cleanliness) and poor physical health is partially mediated by sleep quality [25]. While previous literature has demonstrated an association between sleep and neighborhood factors, they have not fully addressed the directionality of the relationships among specific social capital components and sleep health dimensions. Further, this growing body of literature to suggest neighborhood factors matter for sleep outcomes [16], [17], [18], [19], little attention has been paid to social capital [17], [26], [27]. Although our research is cross-sectional in nature, we examine the relationships among specific social capital and sleep health dimensions.

Social capital refers to the nature and quality of social relationships and connections among individuals in a neighborhood or social network. In addition to the nature of these relationships, social capital has to also do with the resources a person may receive by virtue of their social connections. Social network variables such as social capital are important to consider as evidence shows that health behaviors such as alcohol consumption, smoking [29], [30], and sleep duration [31], are remarkably homogenous among groups of socially connected individuals [28]. Previous research has found low social capital is associated with depression [32], [33] and mortality risk [34], whereas high social capital is associated with physiological well–being [35]. Research has also shown that, after controlling for SES, social capital is associated with self-reported health [36]. With regards to sleep, one study was identified that examined social capital among community-dwelling Japanese individuals, finding poor social capital is associated with insufficient sleep duration [37].

The Social-Ecological Model of Sleep Health [9], [38] posits that poor sleep health is driven by social-contextual factors that underpin health broadly and sleep health specifically. Obtaining a better understanding of relationships between sleep health and social capital may allow for a deeper understanding of the social-environmental causes and/or consequences of poor sleep health. As such, the goal of this paper is to examine discrete measures of social capital and their relationship to a range of sleep health parameters (sleep duration, insomnia, and daytime sleepiness).

Social capital is operationalized in terms of the following dimensions: (1) participation in social or community organization(s) (ie, the number of formal social groups, such as clubs, a person belongs to); (2) neighborhood helping behavior (ie, the degree to which neighbors help each other); (3) neighborhood belonging (ie, the degree to which individuals feel like their neighborhood makes them feel welcome and that they belong); (4) neighborhood trust (ie, the degree to which neighbors trust each other); and (5) neighborhood improvement (ie, the degree to which neighbors work together to improve the neighborhood) [23], [39], [40]. Based on previous findings that demonstrate an inverse association between sleep duration and social capital [37], we extend these findings to hypothesize an inverse association between social capital and three dimensions of sleep health, including: duration, insomnia, and sleepiness. Consistent with prior research examining neighborhood factors [16], [17], [24], [37], we propose to control for SES so as to focus on the association between social capital and sleep health. Using cross-sectional data from the Sleep Health and Activity, Diet and Environment Study (SHADES) survey of adults, we examine following hypothesized associations:

Hypothesis 1 (H1)

Participation in social or community organizations is inversely associated with sleep duration (short and long), insomnia symptoms, and daytime sleepiness.

Hypothesis 2 (H2)

Helping behavior is inversely associated with sleep duration (short and long), insomnia symptoms, and daytime sleepiness.

Hypothesis 3 (H3)

Neighborhood belonging is inversely associated with sleep duration (short and long), insomnia symptoms, and daytime sleepiness.

Hypothesis 4 (H4)

Neighborhood trust is inversely associated with sleep duration (short and long), insomnia symptoms, and daytime sleepiness.

Hypothesis 5 (H5)

Neighborhood improvement is inversely associated with sleep duration (short and long), insomnia symptoms, and daytime sleepiness.

Section snippets

Data source

We analyzed data from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study. SHADES was a community-level study of adults (N = 1007) age 22–60 in the Philadelphia area, including Philadelphia County and the neighboring Delaware, Montgomery, Bucks, and Chester Counties. Respondents were recruited through advertisements posted in various public spaces and community centers. The study included a survey that was completed online or in person between January 2013 and

Characteristics of the sample

Among participants, average age was 34.0 years (s.d. = 9.4 years) and the sample was 50.9% male. Participants were 58.1% non-Hispanic white, 55.9% reported a college degree, and 18.6% reported income of $75,000 or higher. Among participants, recommended duration (7–8 h) was reported by 47.7%. Approximately one third of participants reported no insomnia symptoms (34.8%). Daytime sleepiness scores averaged 7.8 (sd = 4.7). See Table 1 for a detailed summary of the study sample and sleep variables.

Participation in social or community groups

Discussion

There is a large and growing body of literature linking social and environmental factors, such as social capital, with individual health outcomes [36], [52], [53]. While many areas of health have been examined [32], [33], [34], [35], we know less about the relationship between social capital and sleep health. Due to the broad health disparities in sleep and population health, it is vital to identify barriers to sleep health (eg, poor social capital), in order to advance population health [3],

Conclusion

Our study offers preliminary evidence for the link between social capital and several self-reported sleep variables. Specifically, we find preliminary evidence to suggest poor sleep health (eg, short and long sleep duration and insomnia) is associated with poor social capital (eg, less participation in social or community organizations, lower helping behavior and less neighborhood trust, belonging, and improvement). The importance of social network factors, such as social capital, for health

Acknowledgements

This work was supported by grants from the NIH, including R21ES022931, R01MD011600, K24AG055602, K07AG052685, and 5R01MD007716.

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