Cover: Neighborhood Socioeconomic Status, Sleep Duration, and Napping in Middle-To-Old Aged US Men and Women

Neighborhood Socioeconomic Status, Sleep Duration, and Napping in Middle-To-Old Aged US Men and Women

Published in: Sleep, Volume 41, Issue 7 (July 2018). doi: 10.1093/sleep/zsy076

Posted on Mar 16, 2021

by Qian Xiao, Lauren Hale

Study Objectives

Earlier studies have linked neighborhood disadvantage with poor sleep outcomes. However, little is known about the association between changes in one's neighborhood over time and night sleep and napping. In over 300,000 middle-to-old aged Americans, we examined neighborhood socioeconomic status (SES) and change in neighborhood SES in relation to nocturnal sleep duration and napping.


Nocturnal sleep duration and daytime napping were self-reported at baseline (1995–1996). Participants also reported baseline residential addresses, which were linked to US censuses. We derived a neighborhood SES index using census variables and calculated the baseline level and change (1990–2000) in neighborhood SES. Multinomial logistic regression was used to estimate the associations between neighborhood SES over time and nocturnal sleep and napping.


Lower baseline neighborhood SES was associated with short sleep, long sleep, and napping. When compared with the highest quintile of neighborhood SES, the lowest was associated with 46% and 72% increase in relative risk (RR) of reporting very short (< 5 hours) sleep, 28% and 19% higher RR of long (≥9 hours) sleep and 95% and 85% increase in long (≥1 hours) nap in men and women, respectively. Moreover, a decrease in neighborhood SES was associated with higher RR of reporting very short sleep in women; while an improvement in neighborhood SES was associated with an increase in RR of long sleep in men.


Neighborhood disadvantage and worsening neighborhood conditions were associated with unhealthy sleep behaviors. These results reinforce a growing literature on the potential importance of neighborhood context for understanding sleep health.

This report is part of the RAND 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.

RAND 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.