Sleep as a Mediator of the Relationship between Socioeconomic Status and Health: A Hypothesis

Authors

  • EVE VAN CAUTER,

    Corresponding author
    1. Department of Medicine, University of Chicago, 5841 South Maryland Avenue, Chicago, Illinois, USA
      Address for correspondence: Eve Van Cauter, Ph.D., Department of Medicine, MC 1027, University of Chicago, 5841 South Maryland Ave., Chicago, IL 60637, USA. 773-702-0169 (voice); 773-702-9194 (fax). e-mail: evcauter@medicine.bsd.uchicago.edu
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  • KARINE SPIEGEL

    1. Laboratory of Experimental Medicine, Université Libre de Bruxelles, Belgium
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Address for correspondence: Eve Van Cauter, Ph.D., Department of Medicine, MC 1027, University of Chicago, 5841 South Maryland Ave., Chicago, IL 60637, USA. 773-702-0169 (voice); 773-702-9194 (fax). e-mail: evcauter@medicine.bsd.uchicago.edu

Abstract

Abstract: This article discusses the hypothesis that the adverse impact of low socioeconomic status (SES) on health may be partly mediated by decrements in sleep duration and quality. Low SES is frequently associated with a diminished opportunity to obtain sufficient sleep or with environmental conditions that compromise sleep quality. In a recent study, we examined carbohydrate metabolism, endocrine function, and sympatho-vagal balance in young, healthy adults studied after restricting sleep to four hours per night for six nights as compared to a fully rested condition obtained by extending the bedtime period to 12 hours per night for six nights. The state of sleep debt was associated with decreased glucose tolerance, elevated evening cortisol levels, and increased sympathetic activity. The alterations in glucose tolerance and hypothalamo-pituitary-adrenal function were qualitatively and quantitatively similar to those observed in normal aging. These results indicate that sleep loss can increase the “allostatic load” and facilitate the development of chronic conditions, such as obesity, diabetes, and hypertension, which have an increased prevalence in low SES groups.

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