Sociodemographic and cultural determinants of sleep deficiency: Implications for cardiometabolic disease risk

Abstract

Sleep is a biological imperative associated with cardiometabolic disease risk. As such, a thorough discussion of the sociocultural and demographic determinants of sleep is warranted, if not overdue. This paper begins with a brief review of the laboratory and epidemiologic evidence linking sleep deficiency, which includes insufficient sleep and poor sleep quality, with increased risk of chronic cardiometabolic diseases such as obesity, diabetes and hypertension. Identification of the determinants of sleep deficiency is the critical next step to understanding the role sleep plays in human variation in health and disease. Therefore, the majority of this paper describes the different biopsychosocial determinants of sleep, including age, gender, psychosocial factors (depression, stress and loneliness), socioeconomic position and race/ethnicity. In addition, because sleep duration is partly determined by behavior, it will be shaped by cultural values, beliefs and practices. Therefore, possible cultural differences that may impact sleep are discussed. If certain cultural, ethnic or social groups are more likely to experience sleep deficiency, then these differences in sleep could increase their risk of cardiometabolic diseases. Furthermore, if the mechanisms underlying the increased risk of sleep deficiency in certain populations can be identified, interventions could be developed to target these mechanisms, reduce sleep differences and potentially reduce cardiometabolic disease risk.

Psychological Distress Mediates the Association between Food Insecurity and Suboptimal Sleep Quality in Latinos with Type 2 Diabetes Mellitus

“…These findings also have clinical implications for patients with T2DM. Sleep is a basic human need that is important for good health (1,59). Suboptimal sleep is prevalent in patients with T2DM (60).…”

“…Sleep is a basic biological need that, when disturbed, is associated with metabolic disease risk (1)(2)(3)(4)(5)(6), including diabetes mellitus (7,8). The present guidelines recommend 7-8 h of sleep within a 24-h period for adults to 2 Author disclosures: A Bermúdez-Millán, R Pérez-Escamilla, S Segura-Pérez, G Damio, J Chhabra, CY Osborn, and J Wagner, no conflicts of interest.…”

Socio‐demographic predictors of sleep complaints in indigenous Siberians with a mixed economy

“…In non‐transitioning populations, socio‐demographic factors such as age, gender, and socioeconomic status (SES) have a fairly consistent relationship with sleep complaints (Knutson, 2013). From the relatively little data we do have on sleep in transitioning populations, we find an inconsistent relationship between socio‐demographics and sleep complaints (Mazzotti et al, 2012; Stranges et al, 2012).…”

“…Within transitioning populations, factors that are more closely related to physiology, such as gender and age, are often more predictably related to sleep complaints than socio‐cultural factors, such as SES ( ibid ). Older age is also mostly found to be a strong predictor of poorer sleep quality in industrialized populations (Knutson, 2013). However the relationship is not consistent (Grandner et al, 2012), because of the confounding influence of co‐morbidities (Vitiello et al, 2002).…”

“…In many populations, women are more likely to report sleep complaints than men (Haseli‐Mashhadi et al, 2009; Stranges et al, 2012; Hsu et al, 2013). Yet it is unclear whether biological differences between the sexes or separate gender roles/expectations cause gender differentials in sleep (Knutson, 2013). SES has an inconsistent relationship with sleep in transitioning countries (Mazzotti et al, 2012; Stranges et al, 2012).…”