A new study from researchers at the University of Kentucky shows that sleep problems like insomnia are more prevalent than previously thought in Appalachia.
Daniela Moga, a professor at the University of Kentucky College of Pharmacy, is one of the researchers on a study about how socioeconomic factors are related to sleep disorders. She worked with Mairead Moloney, a former UK researcher who is now at the University of Miami, to test the rates of sleep disorders in 12 counties, including Adair, Bell, Estill, Jackson, Knott, Letcher, Lincoln, Perry, Pike, Rockcastle, Russell, and Whitley.
Six of these counties were selected from a 2015 study that identified certain places as insomnia hotspots. The other six were selected as counties with similar factors but not previously identified as hotspots.
“The hypothesis we used to go into the study (was) that we will see less sleep deficiencies in those six counties that are not hotspot and more in the others, and we'll be able to do comparisons using this group designation,” Moga said. “But we did not see a difference in those (counties) that are participating in the study, and that really prevented us from conducting a comparison between the two groups. We had to analyze all of the counties together and really describe what we are seeing, considering all in one group.”
The research started with a pilot study between Moga and Moloney on women in Appalachia to see if cognitive behavioral therapy would help address insomnia. Moga described the research as “highly successful” and said it also helped mental health issues like depression.
“We were still kind of puzzled of why this is happening, why there's this concentration of sleep deficiencies in Eastern Kentucky, in Appalachian Kentucky,” Moga said. “This is kind of what prompted and was the rationale for the current study — the REST-KY, which stands for Researching Sleep Time in Kentucky communities — and this study was designed to really understand what is happening in those communities.”
In the current study, data is being collected from participants over a two-year period through a survey and a health tracking device.
Moga pointed to weather disasters since 2015 that could help explain the results.
“People that had no problems with their sleep before the flooding started to experience sleep deficiencies during that period,” she said. ”And those continued after the flooding, and so this is just an example of something that could have made a difference from where we started, which really informed our hypothesis, to what we are seeing.
The REST-KY study showed nearly 65% of the participants had clinically significant insomnia compared to the 10% national average. About 51% of participants had obstructive sleep apnea, which is higher than the national average of about 38%. Insufficient sleep, meaning less than an average of seven hours of sleep a night, was a problem for about 45% of the participants compared to the national average of 35%.
Other things Moga and her colleagues found were that women had more insomnia, but men had more obstructive sleep apnea. Income, social support and employment were factors in the distribution of sleep deficiencies.
“It's another reason to believe that an intervention using the principles of cognitive behavioral therapy for insomnia would help address not only sleep but some of the mental health problems we are seeing in this population,” Moga said.
The funding for the study continues through the end of June 2027. Moga said there are other impacts on sleep that the team wants to explore, such as extreme weather. Her team is also interested in including different counties in the future.
