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. 2019 Oct;2(4):19.
doi: 10.4148/2572-1836.1051.

Exposure to Violence and Sleep Inadequacies among Men and Women Living in a Shelter Setting

Pooja Agrawal  1 , Julie Neisler  2 , Michael S Businelle  3 , Darla E Kendzor  3 , Daphne C Hernandez  4 , Chisom Odoh  1 , Lorraine R Reitzel  1
Affiliations

Exposure to Violence and Sleep Inadequacies among Men and Women Living in a Shelter Setting

Pooja Agrawal et al. Health Behav Res. 2019 Oct.

Abstract

Background: Exposure to violence may explain sleep inadequacies reported by homeless adults, with women being potentially more susceptible to violence and sleep disturbances than men. This study examined the association between violence and sleep inadequacies among homeless adults and explored differences by sex.

Methods: Adult participants were recruited from a shelter (N=194; 71.1% men, Mage = 43.8±12.2). Participants self-reported victimization and/or witnessing violence (mugging, fight, and/or sexual assault) at the shelter, sleep duration (over an average 24 hours), insufficient sleep (days without sufficient rest/sleep), and unintentional daytime sleep (days with unintentional sleep) in the past month. Linear regressions were used to estimate associations between violence and sleep inadequacies, controlling for sex, age, race, months homeless, and depression. Moderation by sex was examined via an interaction term following mean-centering of variables.

Results: Overall, 20.6% of participants (n=40) reported victimization since moving to the shelter. In the last month, participants reported witnessing an average of 2.9±5.1 acts of violence. Over the same timeframe, participants reported 6.9±2.0 hours of sleep nightly, 11.2±10.7 days of insufficient sleep, and 6.2±8.8 days with unintentional daytime sleep. In adjusted analyses, witnessing violence was associated with insufficient sleep (p=.001). Men and women differed only in age and race in unadjusted analyses; sex was not a significant moderator of any association between violence and sleep in adjusted analyses.

Conclusions: Links between witnessing violence and sleep inadequacies should be considered in shelter health promotion efforts. Successful efforts to minimize violence may reduce insufficient sleep amongst both sexes.

Keywords: Health disparities; homelessness; sleep; victimization; violence.

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Conflict of interest statement

The authors declare that they have no conflicts of interest. Please note that sleep inadequacy data were presented in a previous publication focused on associations with self-rated health (Chang et al., 2015); a subset of those previously reported sleep inadequacy data were used in this paper.

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