Among rural Appalachian adults, sleep deficiency rates were high, with 64.9% having clinically significant insomnia, 51.3% elevated OSA risk, and 44.8% insufficient sleep.
Cross-Sectional (n=327)
Sí
Rural Appalachian adults experience substantially elevated rates of sleep deficiencies compared to national estimates, highlighting the need for targeted, equity-focused interventions addressing social determinants of sleep health.
Abstract Introduction Sleep deficiencies—including insufficient sleep duration, poor sleep quality, and clinical sleep disorders such as insomnia and obstructive sleep apnea (OSA) —represent a significant public health burden, particularly among populations experiencing health inequities. Rural Appalachian communities comprise a federally designated health disparity population with documented geographic "hotspots" of insufficient sleep, yet the prevalence of clinical sleep disorders and their social determinants remain poorly characterized. This study examines sociodemographic, health behavior, and psychosocial correlates of three sleep outcomes (insufficient sleep duration, insomnia, and obstructive sleep apnea risk) among rural Appalachian adults. Methods We analyzed cross-sectional baseline survey data (2023-2025) from the Researching Equitable Sleep Time in Kentucky Communities (REST-KY) study conducted across twelve economically distressed counties in Eastern Kentucky. Eligible participants were English-proficient adults ages 18+ recruited using convenience sampling. Primary outcomes were clinically significant insomnia (Insomnia Severity Index score ≥10), elevated OSA risk (STOP-Bang score ≥3), and insufficient sleep duration (7 hours). Well-validated scales assessed sociodemographics, health behaviors (alcohol use, smoking, diet quality, physical activity, medication use, BMI), and psychosocial factors (social support, trauma, stress, anxiety/depression). We examined bivariate associations using Fisher's exact tests (P. 05). Results Among 327 participants, sleep deficiency rates substantially exceeded national estimates: 64. 9% had clinically significant insomnia (vs. ~10% nationally), 51. 3% had elevated OSA risk (vs. ~38% nationally), and 44. 8% had insufficient sleep (vs. ~35% nationally). Insomnia prevalence showed a steep socioeconomic gradient, declining from 82. 9% among participants earning 20, 000 annually to 44. 4% among those earning 100, 000 (P. 001). Insomnia was significantly associated with female sex, non-full-time employment, living alone, cigarette use, poor diet quality, lower social support, poor self-rated health, polypharmacy, trauma history, anxiety/depression, and high stress. Elevated OSA risk was associated with older age, male sex, cigarette use, higher BMI, poor self-rated health, polypharmacy, and trauma history. Insufficient sleep was associated with lower social support. Conclusion Rural Appalachian adults experience substantially elevated rates of sleep deficiencies compared to national estimates, with distinct sociodemographic and health profiles across sleep conditions. These findings demonstrate the need for targeted, equity-focused interventions addressing social determinants of sleep health in this underserved population. Support (if any) R01MD016236
Moloney et al. (Fri,) conducted a cross-sectional in Sleep deficiencies (insomnia, obstructive sleep apnea, insufficient sleep) (n=327). Sociodemographic, health behavior, and psychosocial factors was evaluated on Clinically significant insomnia (ISI ≥10), elevated OSA risk (STOP-Bang ≥3), and insufficient sleep duration (<7 hours). Among rural Appalachian adults, sleep deficiency rates were high, with 64.9% having clinically significant insomnia, 51.3% elevated OSA risk, and 44.8% insufficient sleep.
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