Sleeping well in a changing climate: The effects of rising temperatures and extreme weather events on sleep and other aspects of health in rural Appalachia

睡眠不足(习惯性睡眠持续时间为≤6小时)是一个代价高昂的公共卫生问题，也是更普遍的问题 在健康差距人群中(例如，少数族裔、社会经济地位低的成年人)。气候变化 气候敏感型灾害对睡眠和下游健康的不利影响 结果。气温升高与睡眠时间和睡眠质量减少有关，负面影响是 在经济资源较少的人群中，这一比例更高。气候变化引发的极端天气事件 通常会导致流离失所、精神创伤和经济不稳定；这些应激源直接损害睡眠。最快的- 与气候有关的灾难恢复日益沉重的负担对现有人口造成不成比例的不利影响 健康差距。这些数据与我们的父母R01直接相关：研究公平睡眠时间 阿巴拉契亚(REST-KY；MD016236)。Rest-KY专注于阿巴拉契亚农村成年人，他们严重的健康 不平等包括多种健康疾病、过早死亡和睡眠不足的高比率。而当 我们的项目旨在评估促进现有区域睡眠和健康的机制。 两年来的缺陷，阿巴拉契亚肯塔基州2022年7月与气候变化相关的灾难 洪灾事件拓宽了我们的研究范围。我们将从6个人中招募400名成年人 肯塔基州阿巴拉契亚地区的睡眠不足热点县(n=200)(25%-58%的成年人报告睡眠不足 睡眠15晚/月)，以及6个类似的农村和经济困难的非热点县。其中五个 12个县遭受大范围洪灾破坏。使用一种混合方法，在纵向爆破设计中 Parent R01将允许我们评估导致睡眠不足和健康的机制 在这个乡村社区生活了几年。本补编是对NOT-HD-23-006NOSI和 涉及美国国立卫生研究院气候变化和健康倡议(健康影响)四大核心支柱中的三个 研究、卫生公平以及培训和能力建设)，通过扩大我们的跨学科团队来带来 气候和健康科学家在一起。拟议的活动完全符合 家长R01：a)收集室外和室内温度、湿度和气压的客观测量结果 压力作为客观睡眠健康的额外预测因子；b)增加对以下信念的量化测量 气候变化与健康，以审查与睡眠和其他健康结果的关系；以及c)增加 定量测量并对父母R01中的洪灾幸存者进行补充定性访谈 评估人们对导致洪灾的因素(包括气候变化)的看法，如何 洪灾影响了他们的睡眠和健康，以及长期恢复的资源和需求。我们的发现将提供 史无前例地洞察气候变化、睡眠和健康在一个研究不足的农村健康中的交集 贫富差距人口。结果将为在快速变化的情况下增加卫生公平的战略提供参考 气候变化，因此将对公共卫生有很大的潜在影响。

Insufficient sleep (habitual sleep duration of ≤6 hours) is a costly public health problem that is more prevalent among health disparity populations (e.g., racial minorities, adults of low socioeconomic status). Climate change and climate-sensitive disasters demonstrate a detrimental impact on sleep and associated downstream health outcomes. Increasing temperatures are linked to diminished sleep time and quality, and negative impacts are heightened among populations with fewer economic resources. Extreme weather events due to climate change often result in displacement, trauma, and economic instability; these stressors directly impair sleep. The fast- growing burden of climate-related disaster recovery disproportionately disadvantages populations with existing health disparities. These data hold direct relevance to our parent R01: Researching Equitable Sleep Time in Appalachia (REST-KY; MD016236). REST-KY focuses on rural Appalachian adults, whose serious health inequities include multiple health morbidities, premature mortality, and high rates of insufficient sleep. While our project was designed to evaluate mechanisms contributing to pre-existing regional sleep and health deficiencies over a two-year period, Appalachian Kentucky’s July 2022 climate-change-related catastrophic flood event has led us to broaden the scope of our research. We will recruit a cohort of 400 adults from 6 insufficient sleep “hotspot” counties (n=200) in Appalachian KY (where 25-58% of adults report insufficient sleep 15+ nights/month), and 6 similarly rural and economically distressed non-“hotspot” counties. Five of the 12 counties suffered widespread flood damage. The use of a mixed method, longitudinal burst design in the parent R01 will allow us to evaluate mechanisms contributing to both sleep deficiencies and health over two years in this rural community. The present supplement is responsive to the NOT-HD-23-006 NOSI and addresses three of the four core pillars of the NIH Climate Change and Health Initiative (Health Effects Research, Health Equity, and Training and Capacity Building) by expanding our trans-disciplinary team to bring together climate and health scientists. The proposed activities are fully within the scope of the aims of the parent R01: a) collect objective measurements of outdoor and indoor temperature, humidity, and barometric pressure as additional predictors of objective sleep health; b) add quantitative measures of beliefs about climate change and health to examine associations with sleep and other health outcomes; and c) add quantitative measures and conduct supplemental qualitative interviews with flood survivors in the parent R01 cohort to evaluate perceptions of factors contributing to the flood disaster (including climate change), how the flood impacted their sleep and health, and long-term recovery resources and needs. Our findings will offer unprecedented insight into the intersections of climate change, sleep and health in an understudied rural health disparity population. Results will inform strategies to increase health equity in the face of a rapidly changing climate, and thus will have strong potential for public health impact.