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Socioeconomic Risk and Sleep Health Among Young Adults With Type 1 Diabetes.

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Title: Socioeconomic Risk and Sleep Health Among Young Adults With Type 1 Diabetes.
Authors: Howard Q; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA., Griggs S; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Source: Western journal of nursing research [West J Nurs Res] 2025 Dec; Vol. 47 (12), pp. 1137-1146. Date of Electronic Publication: 2025 Sep 20.
Publication Type: Journal Article; Randomized Controlled Trial
Language: English
Journal Info: Publisher: Sage Publications Country of Publication: United States NLM ID: 7905435 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-8456 (Electronic) Linking ISSN: 01939459 NLM ISO Abbreviation: West J Nurs Res Subsets: MEDLINE
Imprint Name(s): Publication: Beverly Hills, CA : Sage Publications
Original Publication: [Anaheim, Calif.] Phillips-Allen.
MeSH Terms: Diabetes Mellitus, Type 1*/complications , Diabetes Mellitus, Type 1*/psychology , Socioeconomic Factors* , Sleep*/physiology, Humans ; Female ; Male ; Young Adult ; Adult ; Risk Factors ; Pilot Projects ; Adolescent
Abstract: Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Background: While individual socioeconomic risk factors have been examined in relation to various health outcomes in young adults with type 1 diabetes (T1D), the collective impact of significant socioeconomic risk on multiple dimensions of sleep health in this population remains underexplored.
Objective: We sought to examine the association between socioeconomic risk and sleep health dimensions among young adults with T1D.
Methods: Using baseline data from a pilot randomized controlled trial involving 44 young adults (38.6% female, mean age 20.9 years, mean glycated hemoglobin 8.6%), socioeconomic risks were assessed using the Protocol for Responding to and Assessing Patients Assets, Risks, and Experiences framework. Sleep health was evaluated across 6 dimensions: regularity, satisfaction, alertness, timing, efficiency, and duration. We used actigraphy-derived measures of regularity, timing, efficiency, duration, alertness (via the trail-making test), and self-reported satisfaction. Analyses were adjusted for sex, T1D duration, body mass index, and area-level social vulnerability.
Results: Higher socioeconomic risk composite scores were significantly associated with lower sleep satisfaction (β = 0.556, R2  = 0.281, P  = .001), lower alertness (β = 0.471, R2  = 0.292, P  = .005), and a lower sleep health composite score (β = -0.368, R2  = 0.210, P  = .035). No significant associations were identified for sleep regularity, timing, efficiency, or duration.
Conclusions: Higher socioeconomic risk is associated with lower sleep satisfaction, alertness, and multidimensional sleep health among young adults with T1D, independent of covariates. Addressing socioeconomic risk could offer an important target for interventions to improve sleep and health outcomes in this vulnerable population.
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Grant Information: F31 NR021236 United States NR NINR NIH HHS; R00 NR018886 United States NR NINR NIH HHS; R01 DK136604 United States DK NIDDK NIH HHS
Contributed Indexing: Keywords: actigraphy; sleep health; social vulnerability; socioeconomic risk; type 1 diabetes
Entry Date(s): Date Created: 20250921 Date Completed: 20251114 Latest Revision: 20251128
Update Code: 20251128
PubMed Central ID: PMC12648442
DOI: 10.1177/01939459251366037
PMID: 40975778
Database: MEDLINE
Description
Abstract:Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.<br />Background: While individual socioeconomic risk factors have been examined in relation to various health outcomes in young adults with type 1 diabetes (T1D), the collective impact of significant socioeconomic risk on multiple dimensions of sleep health in this population remains underexplored.<br />Objective: We sought to examine the association between socioeconomic risk and sleep health dimensions among young adults with T1D.<br />Methods: Using baseline data from a pilot randomized controlled trial involving 44 young adults (38.6% female, mean age 20.9 years, mean glycated hemoglobin 8.6%), socioeconomic risks were assessed using the Protocol for Responding to and Assessing Patients Assets, Risks, and Experiences framework. Sleep health was evaluated across 6 dimensions: regularity, satisfaction, alertness, timing, efficiency, and duration. We used actigraphy-derived measures of regularity, timing, efficiency, duration, alertness (via the trail-making test), and self-reported satisfaction. Analyses were adjusted for sex, T1D duration, body mass index, and area-level social vulnerability.<br />Results: Higher socioeconomic risk composite scores were significantly associated with lower sleep satisfaction (β = 0.556, R<sup>2</sup>  = 0.281, P  = .001), lower alertness (β = 0.471, R<sup>2</sup>  = 0.292, P  = .005), and a lower sleep health composite score (β = -0.368, R<sup>2</sup>  = 0.210, P  = .035). No significant associations were identified for sleep regularity, timing, efficiency, or duration.<br />Conclusions: Higher socioeconomic risk is associated with lower sleep satisfaction, alertness, and multidimensional sleep health among young adults with T1D, independent of covariates. Addressing socioeconomic risk could offer an important target for interventions to improve sleep and health outcomes in this vulnerable population.
ISSN:1552-8456
DOI:10.1177/01939459251366037