0382 Neighborhood Characteristics and Sleep Health Among Children: Findings from the National Health Interview Survey 2022, 2024

Abstract Introduction The importance of neighborhood characteristics for sleep health is well-documented among adults, but few nationally representative studies have examined these associations among children. Methods Using data from the 2022 and 2024 National Health Interview Survey (NHIS), we examined associations between perceived features of neighborhoods (e.g., access to sidewalks, access to parks or playgrounds, unsafe traffic, and unsafe crime) and parent-reported sleep problems ((1) waking up not well-rested, (2) difficulty getting out of bed, (3) complaints of tiredness during the day, (4) napping or falling asleep during the day) among school-aged children ages 6-17 years (N=9,403). Each sleep measure was dichotomized to whether participants responded “most days or every day” vs. “some days or never.” A series of separate multivariable logistic regression models were estimated, with potential confounders (sociodemographic characteristics, geographic variables, health behaviors) added in sequential blocks. A sensitivity analysis redefining sleep measures using an alternate threshold of some days/most days/every day vs. never was also estimated. Results In fully adjusted models, unsafe traffic was associated with a 19% higher prevalence of reporting waking up not well-rested (adjusted prevalence ratio (APR): 1.19, 95% CI: 1.08-1.31), a 14% higher prevalence of reporting difficulty getting out of bed (APR: 1.14, 95% CI: 1.02-1.28), and 33% higher prevalence of complaining about being tired during the day (APR: 1.33, 95% CI: 1.14-1.55). Similarly, the presence of crime was associated with a 28% higher prevalence of reporting waking up not well-rested (APR: 1.28, 95% CI: 1.10-1.48), an 18% higher prevalence of reporting difficulty getting out of bed (APR: 1.18, 95% CI: 1.00-1.39), and a 39% higher prevalence of complaining about being tired (APR: 1.39, 95% CI: 1.13-1.72). Physical features of the neighborhoods (e.g., sidewalks and parks) were not related to sleep health following adjustment. Sensitivity analyses using the more broadly defined sleep measures attenuated most associations. Conclusion Traffic and safety features of the neighborhood are associated with children’s sleep health at the national level. Future work could examine these associations using longitudinal data or objective measures for both sleep and neighborhood features. Support (if any)