Sleep as a Mediator of the Relationship between Socioeconomic Status and Health: A Hypothesis
Abstract
A bstract : This article discusses the hypothesis that the adverse impact of low socioeconomic status (SES) on health may be partly mediated by decrements in sleep duration and quality. Low SES is frequently associated with a diminished opportunity to obtain sufficient sleep or with environmental conditions that compromise sleep quality. In a recent study, we examined carbohydrate metabolism, endocrine function, and sympatho‐vagal balance in young, healthy adults studied after restricting sleep to four hours per night for six nights as compared to a fully rested condition obtained by extending the bedtime period to 12 hours per night for six nights. The state of sleep debt was associated with decreased glucose tolerance, elevated evening cortisol levels, and increased sympathetic activity. The alterations in glucose tolerance and hypothalamo‐pituitary‐adrenal function were qualitatively and quantitatively similar to those observed in normal aging. These results indicate that sleep loss can increase the “allostatic load” and facilitate the development of chronic conditions, such as obesity, diabetes, and hypertension, which have an increased prevalence in low SES groups.
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- Authors
- VAN CAUTER, E., & SPIEGEL, K.
- Affiliations
- Université Libre de Bruxelles (BE)
- ORCID
- SPIEGEL, KARINE
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 1999-12
- Volume
- 896
- Issue
- 1
- Pages
- 254-261
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- OpenAlex
- W2003402962
- Cited by
- 179
- References
- 24
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 3 · 2023: 7 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 10 · 2015: 5 · 2014: 6 · 2013: 15 · 2012: 12
- FWCI
- 9.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of the New York Academy of Sciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-41814, R01DK041814)
- National Center for Research Resources (RR-00055)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep duration, sleep quality, socioeconomic status, health disparities, sleep deprivation, glucose tolerance, cortisol, hypothalamic-pituitary-adrenal axis, sympathovagal balance, allostatic load, aging, obesity, diabetes mellitus, hypertension
- MeSH terms
- Adult, Chronic Disease, Diabetes Mellitus, Glucose Tolerance Test, Health Status, Humans, Hydrocortisone, Hypertension, Hypothalamo-Hypophyseal System, Male, Obesity, Pituitary-Adrenal System, Poverty, Sleep Deprivation, Social Class, Prevalence
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