鄰里社會壓力與社會連結、居住安排對老年人睡眠狀況與變化之影響

Neighborhood Stressors and Social Integration, Living Arrangements, and Characteristics and Variabilities of Sleep in Old Age

美國研究證實，居住社區會影響不同群體之個人健康與福祉。然而有關於社區鄰里與健康的研究中，卻尚未探究其對老人睡眠的影響。本研究整合睡眠醫學和社會學理論觀點，探究老人客觀睡眠品質如何受其所處的社區鄰里社會環境所影響。本研究欲驗證兩項假說：（一）居住在危險或孤立的鄰里會危害老人的睡眠；反之，居住在社區連結強的鄰里則會提升其睡眠狀況。（二）老年人的居住安排能調節鄰里特徵對睡眠的影響。本研究使用美國老年健康社會生活調查資料進行統計分析，探究居住鄰里社會環境對客觀睡眠狀況之影響，包含平均睡眠狀況與睡眠變化情形。結果顯示，老人居住於孤立的鄰里較易睡眠中斷；反之，居住於社會連結強的鄰里則有較穩定的睡眠時間長度。此外，老人的居住安排方式調節社區對睡眠的效果。與子女同住或居住安排較為複雜的老人，其居住於危險鄰里對於睡眠的負面效果會被強化。本研究證實社區鄰里特徵能預測老年客觀睡眠狀況，但此影響效果在不同性別間有差異。並且，社區鄰里特徵的效果受老人居住安排方式所調節。

Decades of research has demonstrated that where individuals live can affect their health and well-being. Using theories and research from sociology and sleep medicine, this study will extend the literature on how neighborhoods affect health to examine how neighborhoods and living conditions affect sleep among the elderly, which is an important but overlooked health topic in the social science literature. This study hypothesizes that neighborhood stressors, such as perceived danger, undermine the elderly's sleep, while factors contributing to neighborhood integration, such as social connectedness and a sense of community, promote the elderly's sleep. Second, the study hypothesizes that living arrangements (i.e., living alone or with a spouse, family member, or other person) moderate the relationship between neighborhood and sleep. The analysis uses nationally-representative data from the National Health, Social Life, and Aging Project (N=684), which includes objective assessments of older adults' average sleep characteristics and variabilities. Overall, findings suggest that the social dynamics of neighborhoods can independently predict older adults' sleep characteristics, but the processes are complex and may vary by living arrangements. Specifically, the study finds that neighborhood was not associated with average actigraphic sleep characteristics, but social connectedness was associated with less variability in sleep duration and marginally associated with less variability in wake time after sleep onset. Older adults who lived in intergenerational households had greater variability in sleep fragmentation when they perceived higher degree of danger in their neighborhood, and less variability in sleep fragmentation when they felt social connectedness and a sense of community in their neighborhood. In addition, some gender differences were found.