0946 Psychosocial Factors Contributing to Asthma and Sleep in Urban Children

Introduction Children with persistent asthma in urban environments experience psychosocial stressors that affect asthma management and sleep. Although daily links between lung function and sleep are established, less is known about how specific psychosocial factors contribute to these associations. This study examined whether asthma- and/or sleep-related fear, family stress, acculturative stress, financial strain, and neighborhood safety contributed to the relation between asthma and sleep. Methods Data are from a larger study of asthma and sleep disparities in urban children (R01HL142058; full sample =240). Children ages 7–9 completed a 16-day protocol including daily use of spirometry (FEV₁% predicted) and actigraphy (sleep duration, efficiency, awakenings). Caregivers also completed the validated measures of asthma control (Asthma Control Questionnaire), asthma-related and sleep-related fear, family stress (Family Inventory of Life Events), parental acculturation (Cultural Stress Scale), and neighborhood safety (Neighborhood Safety Scale). Results Preliminary analyses aligned with our prior findings. In the entire sample, higher daily FEV₁ predicted longer sleep duration (β = 0.48, p = .03). Better asthma control was related to longer sleep (β = –7.87, p = .02). In models testing the moderating role of psychosocial variables in the entire sample, financial strain and neighborhood safety moderated the association between lung function and sleep duration. For families with higher financial strain, poorer lung function related to longer sleep. For families with low neighborhood safety, poorer asthma control related to shorter sleep. In models testing ethnic group differences, the moderating effect of financial strain on lung function and sleep duration was significant among Latinos (β =-.67, p = .004). Those reporting greater financial strain showed a weaker association between lung function and sleep duration than those reporting less strain. Similarly, among Latinos, neighborhood unsafety moderated the association between asthma control and sleep duration (β =21.28, p =.01). Among those reporting more neighborhood unsafety, poorer control related to shorter sleep. Main effects will be reported for models. Conclusion Asthma status correlated with sleep outcomes, and psychosocial factors play a role in this association, suggesting consideration of urban stressors in multi-component interventions addressing asthma and sleep disparities. Support (if any) NHLBI R01HL142058; NHLBI T32HL176428; NIGMS P20GM139743