Perceived financial difficulties and sleep in a cohort of adults from the general population: the mediating role of psychosocial and lifestyle factors

Ambra Chessa, Stephanie Schrempft, Viviane Richard, Hélène Baysson, Nick Pullen, María-Eugenia Zaballa, Elsa Lorthe, Mayssam Nehme, Idris Guessous, Silvia Stringhini for the Specchio study group.
Perceived financial hardship and sleep in an adult population-based cohort: The mediating role of psychosocial and lifestyle-related factors.Sleep Health, 22 January 2025, doi: 10.1016/j.sleh.2024.12.006

Abstract

Background: Social inequalities in relation to sleep have already been highlighted, but the mechanisms explaining this association have been less well studied. This study explores the relationship between perceived financial difficulties and sleep in the general adult population, focusing on the mediating role of psychosocial and lifestyle factors.

Methods: We used data from the Specchio cohort, a general population-based study in Geneva, Switzerland, initiated in December 2020. Perceived financial hardship and sleep-related outcomes (insomnia, sleep quality, and sleep duration) were assessed by questionnaire between 2020 and 2021. A counterfactual mediation analysis was conducted to examine the extent to which perceived financial hardship influences sleep via psychosocial factors (psychological distress and loneliness) and lifestyle factors (weight, smoking, and physical inactivity). The models were adjusted for age, gender, level of education, living alone, and chronic illness.

Results: Among the 4388 participants, those experiencing financial difficulties had an increased risk of insomnia (odds ratio: 2.11; 95% confidence interval: 1.70-2.61), of poor sleep quality (odds ratio: 1.69; 95% CI: 1.41-2.02), and of not meeting sleep duration recommendations (odds ratio: 1.40; 95% CI: 1.18-1.66) compared with those without financial difficulties. Psychosocial factors explained 40% of the relationship between financial difficulties and insomnia, 35% with poor sleep quality, and 10% with insufficient sleep duration. Lifestyle factors contributed 8%, 12% and 17% respectively.

Conclusion: Perceived financial difficulties are a significant predictor of poor sleep, an association that can be explained by psychosocial factors and, to a lesser extent, by lifestyle factors. These results underline the importance of integrative approaches to reducing social inequalities in sleep.

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