The relationship between social fragmentation and sleep among adolescents living in Boston, Massachusetts.

BACKGROUND Sufficient sleep is needed for the healthy development of youth. However, only a small minority of adolescents obtain adequate amounts of sleep. Although individual-level correlates of sleep have been identified, studies investigating the influence of the environment on sleep are warranted. METHODS By using cross-sectional data collected from 1878 urban adolescents living in 38 neighborhoods participating in the 2008 Boston Youth Survey (BYS), we determined the association between neighborhood social fragmentation and sleep. Social fragmentation of each participant's residential neighborhood was composed using 2010 US Census data. Multilevel regression models were used to determine the association between social fragmentation and meeting the recommended hours of sleep (>8.5 h) and sleep duration while controlling for individual-level sex, race, age and nativity. RESULTS Moderate (OR = 0.51, 95% CI = 0.27, 0.97) and high (OR = 0.33, 95% CI = 0.18, 0.61) social fragmentation within the residential neighborhood was associated with a decreased likelihood of obtaining adequate sleep. Those in moderate (β = -23.9, 95% CI = -43.1, -4.8) and high (β = -22.1, 95% CI = -43.3, -0.9) socially fragmented neighborhoods obtained fewer minutes of sleep per night. CONCLUSIONS Social fragmentation may be an important determinant of sleep among youth living in urban settings.