Rising Prevalence and Neighborhood, Social, and Behavioral Determinants of Sleep Problems in US Children and Adolescents, 2003–2012

Table 4

Logistic regression models showing covariate-adjusted odds of sleep problems among US children aged 6–17 by neighborhood, sociodemographic, and behavioral characteristics: the 2007 National Survey of Children's Health.

Neighborhood conditions and Socio-behavioral characteristics	Less than 5 days/week of adequate sleep						Less than 7 days/week of adequate sleep
	Sociodemographic model			Full socio-behavioral model			Sociodemographic model			Full socio-behavioral model
	Adj OR	95% CI		Adj OR	95% CI		Adj OR	95% CI		Adj OR	95% CI
Index of neighborhood socioeconomic conditions
20.78–67.09 (least favorable)	1.48	1.21	1.80	1.43	1.18	1.75	1.37	1.16	1.60	1.35	1.15	1.59
67.10–88.32	1.38	1.10	1.73	1.38	1.11	1.72	1.22	1.03	1.45	1.22	1.03	1.45
88.33–104.99	1.45	1.25	1.69	1.42	1.22	1.65	1.12	1.00	1.26	1.11	1.00	1.25
105.00–111.40 (most favorable)	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Neighborhood safety
Safe	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Unsafe	1.44	1.21	1.72	1.40	1.17	1.66	1.21	1.05	1.39	1.19	1.04	1.37
Presence of garbage/litter in neighborhood
Yes	1.33	1.14	1.54	1.29	1.12	1.50	1.32	1.18	1.47	1.30	1.16	1.46
No	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Poorly kept or dilapidated/rundown housing in neighborhood
Yes	1.28	1.09	1.50	1.26	1.09	1.48	1.20	1.07	1.35	1.19	1.06	1.34
No	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Vandalism such as broken windows or graffiti in neighborhood
Yes	1.24	1.03	1.50	1.24	1.03	1.49	1.20	1.04	1.39	1.20	1.04	1.39
No	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Index of neighborhood built environment
46.40–67.04 (low amenities)	1.39	1.11	1.74	1.37	1.10	1.70	1.06	0.89	1.26	1.05	0.89	1.25
67.05–81.39	1.20	1.01	1.43	1.21	1.02	1.44	1.05	0.92	1.19	1.05	0.93	1.19
81.40–104.99	1.14	1.00	1.30	1.14	1.00	1.29	1.05	0.96	1.15	1.05	0.96	1.15
105.00–116.40 (high amenities)	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Neighborhood access to sidewalks or walking paths
Yes	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
No	1.10	0.97	1.24	1.10	0.97	1.24	0.98	0.90	1.07	0.98	0.90	1.07
Neighborhood access to parks or playgrounds
Yes	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
No	1.21	1.05	1.40	1.20	1.04	1.38	1.07	0.96	1.18	1.06	0.96	1.18
Neighborhood access to a recreation or community center
Yes	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
No	1.13	1.01	1.27	1.11	0.99	1.25	1.00	0.92	1.09	1.00	0.91	1.09
Neighborhood access to a library or bookmobile
Yes	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
No	1.24	1.05	1.47	1.24	1.05	1.47	1.05	0.92	1.20	1.05	0.92	1.20
Child's age (years)
6–8	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
9–11	1.38	1.12	1.71	1.33	1.08	1.64	1.20	1.05	1.36	1.18	1.04	1.34
12–14	2.40	2.02	2.85	2.13	1.79	2.54	1.95	1.73	2.20	1.86	1.64	2.10
15–17	4.06	3.45	4.78	3.37	2.83	4.01	2.54	2.25	2.86	2.35	2.06	2.67
Child's sex
Male	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Female	1.11	0.99	1.24	1.08	0.96	1.21	1.02	0.94	1.11	1.00	0.92	1.09
Race/ethnicity
Non-Hispanic white	1.17	0.92	1.49	1.18	0.92	1.51	1.28	1.08	1.51	1.29	1.09	1.53
Non-Hispanic black	1.16	0.90	1.50	1.11	0.86	1.45	0.98	0.81	1.18	0.98	0.81	1.18
Hispanic	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
American Indian/Alaska native	1.06	0.65	1.75	1.08	0.67	1.76	0.97	0.68	1.38	0.98	0.69	1.40
Asian	1.21	0.78	1.87	1.17	0.76	1.82	0.94	0.67	1.31	0.92	0.65	1.29
Hawaiian/Pacific Islander	1.16	0.58	2.31	1.21	0.62	2.38	1.20	0.59	2.46	1.22	0.60	2.51
Non-Hispanic mixed race	1.06	0.77	1.46	1.07	0.78	1.48	1.35	1.04	1.74	1.38	1.06	1.78
Other	0.63	0.34	1.20	0.61	0.32	1.19	0.59	0.36	0.96	0.59	0.36	0.97
Child's nativity/immigrant status
Born to immigrant parents	0.80	0.65	0.98	0.78	0.63	0.96	0.72	0.62	0.84	0.71	0.61	0.83
Born to US-born parents	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Household composition
Two-parent biological	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Two-parent stepfamily	1.01	0.83	1.22	0.98	0.81	1.19	0.96	0.82	1.12	0.95	0.81	1.11
Single mother	1.39	1.16	1.65	1.35	1.13	1.60	1.12	1.00	1.27	1.11	0.99	1.26
Other family type	0.92	0.69	1.23	0.89	0.66	1.20	1.01	0.84	1.22	1.01	0.83	1.22
Place of residence
Metropolitan	1.15	1.01	1.29	1.13	1.00	1.28	0.98	0.89	1.07	0.97	0.88	1.06
Non-metropolitan	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Household poverty status (ratio of family income to poverty threshold)
Below 100%	0.93	0.74	1.16	0.88	0.70	1.10	0.78	0.66	0.93	0.77	0.65	0.91
100%–199%	0.86	0.71	1.04	0.83	0.69	1.00	0.79	0.69	0.91	0.79	0.69	0.90
200%–399%	0.89	0.77	1.03	0.87	0.75	1.01	0.93	0.84	1.03	0.92	0.83	1.02
At or above 400%	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Highest household or parental education level (years)
<12	0.95	0.72	1.25	0.86	0.65	1.13	0.90	0.72	1.12	0.87	0.70	1.08
12	0.91	0.77	1.08	0.85	0.71	1.01	0.87	0.77	0.98	0.86	0.76	0.97
13–15	0.93	0.80	1.08	0.89	0.77	1.03	0.86	0.78	0.96	0.86	0.77	0.96
16+	1.00	Reference		1.00	Reference		1.00	Reference		1.00	Reference
Television watching (number of hours per day)
<1				1.00	Reference					1.00	Reference
1				0.97	0.82	1.14				0.95	0.84	1.08
2				0.94	0.79	1.11				0.95	0.85	1.08
>2				1.07	0.89	1.28				0.91	0.79	1.05
Recreational computer use (number of hours per day)
<1				1.00	Reference					1.00	Reference
1-2				1.22	1.07	1.40				1.08	0.98	1.18
>2				1.41	1.17	1.69				1.20	1.02	1.41
Physical activity (number of days per week)
0				1.47	1.22	1.77				1.21	1.04	1.41
1-2				1.45	1.21	1.75				1.30	1.13	1.49
3-4				1.07	0.93	1.22				1.08	0.98	1.19
5+				1.00	Reference					1.00	Reference
Secondhand smoke exposure
Yes				1.23	1.04	1.46				1.07	0.94	1.23
No				1.00	Reference					1.00	Reference

Sociodemographic logistic models included child's age, sex, race/ethnicity, nativity, household composition, metropolitan/nonmetropolitan residence, household poverty and education levels, and neighborhood social conditions or built environments. The full logistic model included neighborhood conditions and sociodemographic and behavioral covariates.