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May 10, 2026SLEEP

0303 Associations Between Social Determinants of Health and Long-term Fitbit-Measured Sleep Duration and Variability in the All of Us Research Program

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Why the study?

Prior research on sleep and social determinants of health relied largely on subjective measures or short-term actigraphy, leaving limited evidence on associations with objectively assessed long-term sleep patterns in large populations.

Are more favorable Social Determinants of Health associated with longer and more regular sleep duration?

Population

13,282 participants from the All of US Research Program contributing at least 6 months of Fitbit data

Comparison

Higher vs lower standardized SDOH scores overall and across domains

Design

Observational cohort study using multiple linear regression

Follow-up

Mean 1247 days (range 181-4174)

Key result

A 1-SD increase in overall social determinants of health score was associated with 6.0 minutes (95% CI: 3.4-8.7) longer sleep duration and 3.6 minutes (95% CI: -4.8 to -2.4) lower sleep duration SD.

Authors

ENEsha NarlaMBMay BaydounDJDayna Johnson

Discussion

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Overview

Clinicians should exercise caution generalizing sleep norms across SDOH groups; extends subjective data with objective long-term patterns but leaves open causality.

Key Points

  • This research aims to investigate the links between social determinants of health (SDOH) and long-term objectively measured sleep patterns.
  • Analysis of 13,282 participants from the All of Us Research Program with at least 6 months of Fitbit data.
  • Calculated mean sleep duration and variability; assessed SDOH through validated surveys and adjusted for demographic factors.
  • Examined associations using multiple linear regression.
  • A 1-SD increase in overall SDOH score was linked to 6.0 minutes longer sleep duration (95% CI: 3.4, 8.7).
  • Social/community context showed the strongest correlation with a 1-SD increase resulting in 4.8 minutes longer sleep duration (95% CI: 2.6, 7.0).
  • No significant associations noted for the neighborhood environment domain.

Study Design

Type

Observational (n=13,282)

Multicenter

Yes

Structured PICO

Are more favorable Social Determinants of Health associated with longer and more regular sleep duration?

P
Population
13,282 participants from the All of Us Research Program with at least 6 months of Fitbit data, mean age 58.9 years, 70.3% female.
I
Intervention
Higher Social Determinants of Health (SDOH) scores (overall and domain-specific)
C
Comparator
Lower Social Determinants of Health (SDOH) scores
O
Outcome
Mean sleep duration (in minutes) and sleep duration standard deviation (SD) across all available dayssurrogate

Main Result

Effect estimate: Beta 6.0 minutes (sleep duration) (95% CI 3.4-8.7)

More favorable social determinants of health are associated with modestly longer and more regular objectively measured sleep duration.

Cite This Study

Narla et al. (2026) conducted an observational in Sleep duration and variability (n=13,282). Social determinants of health (SDOH) was evaluated on Mean sleep duration and sleep duration standard deviation (Beta 6.0 minutes (sleep duration), 95% CI 3.4-8.7). A 1-SD increase in overall social determinants of health score was associated with 6.0 minutes (95% CI: 3.4-8.7) longer sleep duration and 3.6 minutes (95% CI: -4.8 to -2.4) lower sleep duration SD.

synapsesocial.com/papers/6a0021cdc8f74e3340f9cbe8https://doi.org/10.1093/sleep/zsag091.0303
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