Sleep Health Profiles in Middle-aged Workers in Relation to Cardiovascular and Cognitive Health

Middle-aged workers are vulnerable to having poor sleep, which is a public concern as it may lead to decreased productivity at work and increased risks of health problems over time. Most studies have associated one aspect of sleep (often focusing on sleep duration) with work or health-related variables, lacking a comprehensive understanding of how the combinations of multiple dimensions of sleep within individuals are associated with work-related stress and health outcomes. For example, a combination of sufficient sleep duration, regular sleep/wake, efficient sleep, and no insomnia symptom may be more predictive of concurrent and later cardiovascular and cognitive health than sleep duration alone. We propose to use multidimensional sleep health profiles that measure ?which? and ?how many? sleep problems co-occur within individuals. Harmonizing two independent project data sets from the Midlife in the United States Study (MIDUS) and Work, Family & Health Study (WFHS), the proposed study aims at examining the relationships between work-to-nonwork conflict (work stress carried over to and interfering with family and personal activities including sleep), sleep health profiles, and cardiovascular and cognitive health. Aim 1 will identify sleep health profiles in middle-aged workers and examine the associations of work-to-nonwork conflict with the sleep health profiles. Using extensive measures of self- reported and actigraphy-measured sleep, we will identify a priori-defined and empirically-derived sleep health profiles in diverse forms and will evaluate reproducibility of sleep health profiles across MIDUS and WFHS samples. Aim 2 will examine the associations of the sleep health profiles with cardiovascular health outcomes. Taking advantage of two cohorts in MIDUS that were sampled before and after the U.S. Great Recession period (2007-2009), we will also examine the health impacts of a macro- level stressor, whether those who were exposed to the economic recession exhibit a stronger link between sleep health profiles and cardiovascular outcomes than a propensity-matched sample who were not exposed to the recession but otherwise equal on all observables. Aim 3 will further examine the associations of the sleep health profiles with cognitive outcomes, leveraging MIDUS longitudinal cognitive data that include objectively measured episodic memory and executive functioning. We will also explore (1) whether sleep health profiles mediate the relationships between work-related stress (work-to-nonwork conflict) and cardiovascular and cognitive health, (2) potential moderation by sex and race, and (3) daily characteristics that predict optimal sleep health nights (using machine-learning). The proposed sleep health profiles can be broadly used to improve prediction accuracy in health screening tools. Focusing on middle-aged workers will contribute to decreasing health disparities in the workforce and promoting work productivity and healthy aging. Findings will inform the development of sleep-focused interventions to improve sleep and health among middle-aged workers who are in greater need.