Sleep Disturbances are Consequences or Mediators between Socioeconomic Status and Health: A Scoping Review

Abstract

The variations in socioeconomic status (SES) between different social classes of a population correspond to differences in accessibility to all resources available and able to improve global health. SES can influence global health trajectory for an individual or a community, depending if SES is low or high. Sleep is sensitive to environmental stimuli, as well as living conditions. Plenty of studies linked sleep complaints with mood disorders, allostatic load or circadian disruption; but very few or none investigated deeply what happened earlier to sleep depending of SES. While SES is now known as one of the main determinants for a good health and a good aging, its influence on sleep disorders (SD) is not well understood. SES is a concept, not directly observable but estimated using indicators like income, education, occupational status and area of living. Even if recent evidence suggested that few of SES indicators like occupational status are linked with sleep disturbances, the relation between SES and health in general with sleep as an outcome or a mediator is not well documented. This scoping review synthetized studies which investigated physiological and psychological mechanisms resulting from a low SES and linked them with sleep disturbances as consequences or as mediators. This review also explore a possible role played by sleep in the relation between socioeconomic status and health inequalities.

Insomnia, excessive daytime sleepiness, anxiety, depression and socioeconomic status among customer service employees in Canada

“…Regarding anxiety and depression, few studies reported influence of type of work and type of shift on neuropsychiatric outcomes (Averina et al, 2005; Harris et al, 2010). The present study is the first which reports prevalence and proportion of anxiety and depression in a population of customer service employees, and also confirms the existence of a strong relation between socioeconomic status and mood disorders in line with few articles reporting possible relation between socioeconomic status and health (Mulatu and Schooler, 2002; Averina et al, 2005; Phelan et al, 2010; Hawkley et al, 2011; McEwen, 2017; Etindele Sosso et al, 2018a; Etindele Sosso et al, 2018b; Etindele Sosso and Papadopoulos, 2018; Etindele et al, 2019; Sosso et al, 2019). The present study alerts on the potential effect of working full time in a call center as a risk factor for neuropsychiatric illnesses.…”

Longitudinal Reciprocal Relationships Between Subjective Social Status and Short Sleep Duration in a German Population-Based Sample

“…Possible explanations for this link might be that lower socioeconomic resources result in worse environmental conditions (eg, regarding housing, regarding noise), less favorable working circumstances (eg, need to maximize available time for work), but also in the experience of financial stress which may interfere with adequate sleep. 11 , 12 , 21 , 40 Importantly, the observed lack of an association between local SSS and short sleep duration does not necessarily imply that one’s perceived social position in the closer social environment is irrelevant for sleep duration. As described above, the assessment of local SSS in this and previous research did not explicitly refer to traditional indicators of socioeconomic status and thus attempted to capture a broader range of status-related aspects beyond socioeconomic status (eg, perceived respect and social rewards from others, social standing within meaningful social groups).…”

Mutual Relationship Between Sleep Disorders, Quality of Life and Psychosocial Aspects in Patients With Psoriasis

“…Sleep loss and insufficient rest lead to increased stress and even anxiety development (27). Prolonged sleep loss may alter neurotransmission processes and neuroendocrine reactivity similarly as observed in depression, which could provide further evidence that chronic stress experience and sleep deprivation may trigger mood disorders (28).…”

“…On the one hand, increased activation of the HPA axis results in sleeplessness symptoms; on the other hand, sleep disturbances act due to promoting the activity of the same axis ( 19 ). It results in increased secretion of cortisol and pro-inflammatory cytokines, e.g., interleukin 6 (IL-6) and tumor necrosis factor alpha, which negatively affect immune and autonomic nervous system function, also leading to impairment of cognitive function and change in pain perception ( 4 , 28 ). Numerous studies reveal decreased serum adiponectin levels or increased ghrelin and leptin levels in individuals affected by sleep deprivation ( 29 , 30 ).…”

“…The role of insufficient sleep duration or interrupted sleep course is previously reported as a factor contributing to susceptibilities to infectious diseases ( 32 ). Increased risk of neoplasms due to sleep disturbances is also mentioned ( 28 ).…”