Sleep Disturbances Are Mediators Between Socioeconomic Status and Health: a Scoping Review

Understanding the etiology of socioeconomic disparities in health could assist public health authorities in preventing the morbidity of socially disadvantaged individuals. We undertook a scoping review to test the hypothesis that poor sleep is located in the pathway from low socioeconomic status (SES) to poor health. After electronic database searching, we included observational studies with general population participants that presented mediation effects of sleep parameters on the association between SES levels and various health measures. For each comparison across studies, we charted total, direct, and indirect effects and mediation proportion and compared them by health outcome measure and by direction of mediation effect. Twenty articles met our inclusion criteria. Only half of the analyses yielded mediation effects in the expected direction, the rest being mostly non-significant. Sleep measures explained 29% of the SES-mental health gradient, but much lower proportions for other outcomes. More research is needed to clarify the impact of sleep on the social gradient in health.