A Preliminary Study of a Composite Sleep Health Score

Associations with Psychological Distress, Body Mass Index, and Physical Functioning in a Low-Income African American Community

Published in: Sleep Health, Volume 5, Issue 5, pages 514–520 (October 2019). doi: 10.1016/j.sleh.2019.05.001

Posted on RAND.org on March 16, 2021

by Amy Soo Jin DeSantis, Tamara Dubowitz, Bonnie Ghosh-Dastidar, Gerald P. Hunter, Matthew Buman, Daniel J. Buysse, Lauren Hale, Wendy M. Troxel

Read More

Access further information on this document at Sleep Health

This article was published outside of RAND. The full text of the article can be found at the link above.

Objectives

Although multiple individual sleep measures (eg, sleep duration, satisfaction) have been linked to a wide range of physical and mental health conditions, scant research has examined how individual sleep dimensions may act independently or additively to influence health. The current study investigates associations of 5 sleep dimensions (duration, satisfaction, efficiency, timing, and regularity), analyzed separately and simultaneously, with psychological distress, body mass index, and physical functioning among a low-income, predominantly African American population.

Design

We constructed a composite sleep health (SH) score from the sum of scores, representing "good' and "poor" ranges of 5 sleep measures (range 0–5).

Setting

Two low-income, predominantly African American neighborhoods in Pittsburgh.

Participants

Participants included 738 community-dwelling adults (78% female and 98% black).

Measurements

Actigraphy-based measures of sleep duration, regularity, timing, and efficiency, and self-reported sleep satisfaction. Outcomes included self-reported psychological distress, physical functioning, and measured body mass index (BMI).

Results

Each 1-unit higher SH score was associated with 0.55-unit lower psychological distress score (range 0–24) and 2.23-unit higher physical functioning score. Participants with at least 2, 3, or 4 sleep dimensions in the "healthy" range, vs fewer, had lower psychological distress scores. Greater sleep satisfaction was associated with higher physical functioning, and longer sleep duration was associated with lower physical functioning. Neither the composite SH score nor any of the individual sleep dimensions were associated with BMI.

Conclusions

Assessing multiple sleep dimensions may provide a more comprehensive understanding of associations of sleep with psychological distress than assessing any single sleep dimension. Although no sleep measures were related to BMI in the current sample, analyses should be replicated in other samples to determine generalizability.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.