In this brief review article, we provide an overview of recent (since 2010) scientific contributions to our understanding of the social and environmental determinants of sleep health. In particular, we focus on three areas where we saw the most contributions to the determinants of sleep health among children, adolescents, and adults. First, studies of neighborhood context and sleep health find that sleep quality and quantity are lower in disadvantaged neighborhoods. These negative associations are often stronger for women than for men. Second, family factors matter for sleep health. Children from families with more parental resources sleep better than do children from families without such resources. Adults with children sleep less than those without, and work-family conflict is an impediment to good sleep. Third, media use is problematic for sleep health. Around the world, higher levels of screen media use are associated with lower quality and quantity of sleep. Future research on the social and environmental determinants of sleep health will grow out of these three areas of current research. In addition, we anticipate new research in the international realm and in the area of interventions designed to improve the population’s sleep health.

Objective Although numerous studies among adults have shown a U-shaped association between sleep duration and health outcomes, fewer studies have investigated the theory that children also have an optimal sleep duration range, with both lower and upper limits. We evaluated whether children's sleep duration at ages 5 and 9 has a U-shaped association with both behavioral problems and physical health at age 9. Method We analyzed data from 1,965 participants in a longitudinal birth cohort, the Fragile Families and Child Wellbeing Study. This sample of children was 52% male and approximately 22% non-Hispanic white, 52% non-Hispanic black, 23% Hispanic, and 3% some other race/ethnicity. The child's primary caregiver reported the predictor of interest: sleep duration at age 5 and age 9. Both children and primary caregivers reported on outcomes of the child's behavior problems (internalizing and externalizing) and overall physical health. Results We found that the association between children's sleep duration and wellbeing was typically nonlinear and U-shaped. Adjusting for their sleep duration at age 5, children who sleep either too much or too little at age 9 had higher levels of behavior problems and scored lower on a global measure of physical health. These non-linear patterns were similar whether children or primary caregivers reported child outcomes, with the exception that there was a linear and increasing association of longer sleep duration and caregiver-rated child health. Conclusions This study highlights that both short and long sleep duration may be risk factors for adverse behavioral and health outcomes in school-aged children.

Objective To test the association between sleep duration and telomere length in a pediatric population. Study design We analyzed cross-sectional data for 1,567children from the age 9 study wave of the Fragile Families and Child Wellbeing Study, a population-based birth cohort of children born between 1998–2000 in large American cities (population > 200,000). We measured telomere length using quantitative PCR, and children’s typical nightly sleep duration was reported by their primary caregivers. Using linear regression models, we estimated the association between sleep duration and telomere length in both unadjusted models and adjusting for a number of covariates. Results We found that children with shorter sleep durations have shorter telomeres than children with longer sleep durations. Each hour less of nightly sleep duration is associated with having telomeres that are 0.015 log-kilobases per chromosome shorter (p < 0.05). We found no difference in this association by race, sex, or socioeconomic status. Conclusions We provide preliminary evidence that children with shorter sleep durations have shorter telomeres. This finding is consistent with a broader literature indicating that sub-optimal sleep duration is a risk for increased physiological stress and impaired health. Future research should address the limitations of our study design by using longitudinal study designs and telomere measurements, measuring sleep duration via polysomnography or actigraphy, and assessing the intermediate biological mechanisms of the link between sleep and telomere dynamics.

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Childhood exposure to violent contexts is associated with risky adolescent health behaviors, but the associations are context and behavior specific. After including covariates, we find no association between childhood exposure to violent contexts and obesity risk behavior.