Association between household sleep environment and sleep health characteristics in middle-aged adults: The CARDIA sleep study

Objectives: Household environmental factors and sleep hygiene may contribute to poor sleep health. We identified associations between household sleep environment (HHSE) and sleep health characteristics in White and Black adults. Methods: This study included cross-sectional data from the CARDIA sleep ancillary study at Year 35 (n = 711). HHSE was assessed in two domains (sleep disruptors and sleep hygiene) using a questionnaire, and higher scores indicated more sleep disruptors or poorer sleep hygiene. Sleep outcomes included (1) self-reported sleep quality and daytime sleepiness and (2) actigraphy-measured sleep duration, sleep percentage, sleep timing (midpoint sleep time), and sleep regularity. We used robust regression to estimate differences in sleep outcomes corresponding to each 1-point increment in HHSE. Racial differences in associations of interest were examined by testing for interaction. Results: Participants’ mean age was 61.5 (SD = 3.6) years, 63% were women, and 36.7% were Black. After multivariable adjustment (β [95% CI]), more sleep disruptors (0.145 [0.04, 0.24]) and poor sleep hygiene (0.170 [0.10, 0.23]) were associated with self-reported poor sleep quality. Poor sleep hygiene was associated with actigraphy-measured shorter sleep duration (−1.397 [−2.73, −0.01]) and sleep irregularity (0.017 [0.01, 0.02]). In stratified analysis, more sleep disruptors were associated with poor sleep quality (0.320 [0.10, 0.53]) and greater daytime sleepiness (0.330 [0.11, 0.54]) only in Black participants. Conclusions: Poor HHSE was related to self-reported poor sleep quality and to objective shorter sleep duration and sleep irregularity. Targeted interventions to mitigate sleep disruptors and promote good sleep hygiene may help to improve sleep health.