title: Sleep insufficiency and the natural environment: Results from the US Behavioral Risk Factor Surveillance System survey.
abstract: BACKGROUND
  Exposure to the natural environment may improve health behaviors and mental health outcomes such as increased levels of physical activity and lower levels of depression associated with sleep quality. Little is known about the relationship between insufficient sleep and the natural environment.
  
  
  OBJECTIVE
  To determine whether exposure to attributes of the natural environment (e.g., greenspace) attenuates the likelihood of reporting insufficient sleep among US adults.
  
  
  METHODS
  Multiple logistic regression models were used to explore the association between self-reported days of insufficient sleep (in the past 30days) and access to the natural environment in a multi-ethnic, nationally representative sample (n=255,171) of US adults ≥18years of age enrolled in the 2010 Behavioral Risk Factor Surveillance System.
  
  
  RESULTS
  Using 1-to-6days of insufficient sleep as the referent group for all analyses, lower odds of exposure to natural amenities were observed for individuals reporting 21-to-29days (OR=0.843, 95% confidence interval (CI)=0.747, 0.951) of insufficient sleep. In stratified analyses, statistically significant lower odds of exposure to natural amenities were found among men reporting 7-to-13-days (OR=0.911, 95% CI=0.857, 0.968), 21-to-29-days (OR=0.838, 95% CI=0.759, 0.924), and 30-days (OR=0.860, 95% CI=0.784, 0.943) of insufficient sleep. Greenspace access was also protective against insufficient sleep for men and individuals aged 65+.
  
  
  CONCLUSIONS
  In a representative sample of US adults, access to the natural environment attenuated the likelihood of reporting insufficient sleep, particularly among men. Additional studies are needed to examine the impact of natural environment exposure on sleep insufficiency across various socio-demographic groups.
authors.affiliation: Department of Kinesiology and Community Health, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States; Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States; Bouve College of Health Sciences, Northeastern University, Boston, MA, United States. Electronic address: dgrigs1@illinois.edu.
authors.forename: Diana S
authors.initials: DS
authors.lastname: Grigsby-Toussaint
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
authors.forename: Kedir N
authors.initials: KN
authors.lastname: Turi
authors.affiliation: Department of Geography, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
authors.forename: Mark
authors.initials: M
authors.lastname: Krupa
authors.affiliation: Center for Healthful Behavioral Change, Department of Population Health, New York University School of Medicine, New York, NY, United States.
authors.forename: Natasha J
authors.initials: NJ
authors.lastname: Williams
authors.affiliation: Center for Healthful Behavioral Change, Department of Population Health, New York University School of Medicine, New York, NY, United States.
authors.forename: Seithikurippu R
authors.initials: SR
authors.lastname: Pandi-Perumal
authors.affiliation: Center for Healthful Behavioral Change, Department of Population Health, New York University School of Medicine, New York, NY, United States.
authors.forename: Girardin
authors.initials: G
authors.lastname: Jean-Louis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D040343:Behavioral Risk Factor Surveillance System; D004777:Environment; D005006:Ethnicity; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D012892:Sleep Deprivation / Q000517:prevention & control* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States
keywords: Environment; Greenspace; Natural environment; Sleep; Sleep quality