Day-by-day changes in the indoor environment and sleep health among African American adults.

OBJECTIVES: The study aimed to examine the association between day-by-day changes in the indoor physical environment and dimensions of sleep health among African American adults. METHODS: A total of 36 African American participants with at least five consecutive days of objective sleep measured by actigraphy (417 person-days) were included in the analysis. Indoor environmental factors, including temperature, carbon dioxide, noise, humidity, and barometric pressure, were objectively measured by an indoor environmental monitor. Linear mixed models were utilized to assess the within-person association between day-by-day changes in indoor environmental factors and sleep efficiency, wakefulness after sleep onset, sleep duration, and linear models for the association with sleep regularity, adjusting for sex, age, educational attainment, and the number of household members. The joint associations of all factors with sleep measures were assessed using quantile g-computation. RESULTS: The participants' mean (standard deviation) age was 55.3 (8.1), and most were female and had a bachelor's degree or higher. In complete case analysis (N = 29, 288 person-days), higher noise levels were associated with lower sleep efficiency (β = -1.81%, 95% CI: -2.00, -0.45), especially among those in the highest quartile vs. the lowest (β = -2.73%, 95% CI: -4.91, -0.54). Higher pressure levels were associated with longer sleep duration (β = 15.22 minutes, 95% CI: 1.11, 28.02) and more irregular sleep (β = 16.07 minutes, 95% CI: 1.40, 30.73). Having higher levels of all environmental factors was associated with lower sleep efficiency (β = -1.38%, 95% CI: -3.01, 0.26). Multiple-imputation analysis yielded consistent results. CONCLUSIONS: Day-by-day changes in indoor physical environment were associated with sleep efficiency, duration, and irregularity among African American adults in the Atlanta Metro area.