Food Insecurity and Housing Insecurity Associated With Decreased Sleep Regularity in Adolescents

While disparities in adolescent sleep health are well recognized, few studies focus on sleep regularity, a sleep parameter associated with negative physical and mental health consequences. This study aimed to evaluate the association between socio-contextual factors and sleep regularity in healthy adolescents recruited from primary care.

Data were derived from the baseline assessment for a pilot clinical trial that investigated a digital sleep intervention for teens aged 12 to 14. Socio-contextual factors included cut-off utilities, food insecurity, housing insecurity, neighborhood social cohesion, amenities, and perceived safety. The primary outcome of interest was actigraphy-measured sleep regularity quantified by the sleep regularity index (SRI; range 0-100; score = 100 indicates max regularity). Multivariable linear regression, adjusted for sex and age, was performed to examine the relationships between socio-contextual measures and sleep regularity.

Sample included 54 youth (mean age 12.94, 44.44% sex assigned female at birth). In the multivariable models, food and housing insecurity were significantly associated with decreased sleep regularity including worry that food would run out (β = -9.23, 95% CI: -13.62 to -4.84, P<.001), food running out (β = -10.56, 95% CI: -15.12 to -5.99, P<.001), and housing insecurity (β = -17.04, 95% CI: -31.26 to -2.82, P<.05). No other significant associations were found.

Among healthy adolescents recruited from primary care, those living in food- or housing-insecure households experienced decreased sleep regularity. Further understanding the interplay between socio-contextual factors and sleep is necessary to inform interventions and anticipatory guidance via clinical guidelines for health care providers.