Socioeconomic Position and Excessive Daytime Sleepiness: A Systematic Review of Social Epidemiological Studies

Abstract

The objectives of this empirical study are to describe and discuss the current literature available on the relationship between excessive daytime sleepiness (EDS) and the socioeconomic position (SEP) as well as to provide recommendations for consideration of SEP in sleep medicine and biomedical research. Databases Medline/PubMed, Web of Science, Google scholar and Scopus were screened from January 1990 to December 2020 using PRISMA guidelines and 20 articles were included in the final synthesis. Nineteen studies were cross-sectional and one study was longitudinal. Among these studies, 25.00% (n = 5) are focused on children and adolescent and the remaining 75.00% (n = 15) focused on adults and seniors. Ages ranged from 8 to 18 years old for children/adolescent and ranged from 18 to 102 years old for adults. Main SEP measures presented in these studies were education, income, perceived socioeconomic status and employment. The sample size in these studies varied from N = 90 participants to N = 33,865 participants. Overall, a lower educational level, a lower income and full-time employment were associated with EDS. Symptoms of EDS are prevalent in women, especially those with a low income or no job; and children and adolescents with difficult living conditions or working part time reported more sleep disturbances. SEP is already considered as an important determinant for many health outcomes, but if SEP is embedded in the experimental design in psychosomatic research, biomedical research and clinical practice as a constant variable regardless of outcome; it will move forward future investigations.

Causes of sleep disturbance in human immunodeficiency virus-infected individuals

“…Like low SES, behavioral risk factors, such as smoking, alcohol and drug use, or eating disorders also negatively affect sleep quality. 23 In our study, SES could not be evaluated clearly because we could not reach a sufficient number of patients. However, further examination of sleep disorders, taking into account the impact of SES, will contribute to how social inequalities can cause sleep disorders and will guide prevention and treatment.…”

Determinants of Health Inequalities in Iran and Saudi Arabia: A Systematic Review of the Sleep Literature

“…So, future studies in this region should consider moving forward the knowledge by using an objective measure of sleep to verify trends reported by local authors. There are also a lot of sleep disorders not studied, while a few such as OSA can be linked to other sleep disorders such as excessive daytime sleepiness [ 8 , 39 , 40 ], and thus have to be studied. Finally, the heterogeneity of SES involved a deep consideration of the sociological approaches and psychological theories in biomedical research, in order to be able to accurately capture this complex concept.…”

“…Health inequalities are associated with economic and societal impact on every government, regardless of GDP and the global well-being of an entire population [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. Health inequalities can be observed with the cardiovascular system [ 9 ], respiratory system [ 10 ] or sleep mechanisms [ 1 , 2 ].…”

Pharmacopuncture Effects on Insomnia Disorder: Protocol for a Multi-Site, Randomized, Acupuncture-Controlled, Clinical Trial

“…Recently, several studies reported that sleep health and sleep disturbance are correlated to SES. Poor income, low education, unemployment, and difficult living conditions are reportedly associated with poor sleep quality, insomnia, and excessive daytime sleepiness [ 15 , 16 ]. Moreover, a meta-analysis showed that the influence of SES on sleep health can be measured objectively and quantitatively through actigraphy or polysomnography [ 17 ].…”