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Abstract Introduction Rural populations experience a higher prevalence of insomnia and insufficient sleep compared to urban populations. The purpose of this study was to compare self-reported sleep disturbances and objective sleep duration measured using consumer-wearable devices among individuals living in rural versus non-rural communities. Methods Participants in this analysis were from the National Institutes of Health (NIH) All of Us (AOU) Research Program, a diverse US health database. We assessed rurality using an item on a self-report questionnaire measuring geographic isolation, dichotomized as rural or non-rural. Sleep disturbance symptoms were measured using item 3 on the Patient Health Questionaire-9, which assesses trouble falling or staying asleep or sleeping too much in the past 2 weeks. Objective total sleep time (TST) was measured using Fitbit devices. Participants with 14 days of wearable data were excluded from TST analyses. Results Chi-squared analysis revealed that AOU participants living in rural communities were more likely to report sleep disturbance symptoms at least several nights per week (75.4%, n=1,552, ◻2(1) =165.6, p.001) compared to individuals living in non-rural communities (59.2%, n=59,778). Linear regression analysis revealed that rurality was significantly associated with increased self-reported sleep disturbances (rural M=1.44, SD=1.12; non-rural M=.92, SD=.97; b=.424, SE=.025, F(3,59812)=1187, p.001, adjusted R2=.056) and decreased objective average TST (rural M=351 min, SD=73, n=356; non-rural M=363 min, SD=75, n=11,760; b=-15.769, SE=3.980, F(3,12112)=75.93, p.001, adjusted R2=.018), when controlling for age and sex. Conclusion Our findings align with previous research that individuals in rural communities typically experience poorer sleep than those living in non-rural communities. These results suggest a need for targeted sleep interventions for individuals living in geographically isolated areas of the US. Moreover, these findings imply that future research examining geographic sleep health disparities is warranted. Support (if any) The AOU Research Program is supported by the NIH and the contributions of its participants.
Leete et al. (Sat,) studied this question.