Congratulations to Mairead Moloney, PhD and her co-authors on the publication of a paper “Social Determinants of Sleep Health Inequities Among Rural Appalachian Adults” by JAMA Network Open journal.
Dr. Moloney is an Associate Professor in the Miller School of Medicine’s Department of Informatics and Health Data Science, and an IDSC Core Faculty member under the Population Health Informatics research focus area. In addition to her research, she leads the Education Vertical for the Department.
REST-KY, an NIH-funded study, documents some striking findings about sleep health disparities among adults in rural Eastern Kentucky. Among 327 participants from a federally designated health disparity population, nearly 65% met criteria for clinically significant insomnia—compared to roughly 10% nationally—with a steep socioeconomic gradient and strong associations with psychosocial factors like stress, trauma, and social isolation. This work, Dr. Moloney shared “really speaks to the power of data science approaches in uncovering health inequities in underserved communities.”
Introduction
Sleep deficiencies—including insufficient sleep duration, poor sleep quality, and clinical sleep disorders such as insomnia and obstructive sleep apnea (OSA)—represent a significant public health burden, particularly among populations experiencing health inequities.1,2 Rural Appalachian communities include a federally designated health disparity population with documented geographic insufficient sleep hotspots, yet the prevalence of clinical sleep disorders and their social determinants remain poorly characterized.3–5 This study investigated the sociodemographic, health behavior, and psychosocial associations of 3 sleep outcomes (insufficient sleep duration, insomnia, and obstructive sleep apnea risk) among rural Appalachian adults.
Methods
This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cross-sectional studies. Procedures were approved by the University of Kentucky institutional review board and participants provided informed consent electronically. The authors analyzed cross-sectional baseline survey data (2023-2025) from the Researching Equitable Sleep Time in Kentucky Communities (REST-KY) study6 conducted across 12 economically distressed Eastern Kentucky counties.
Eligible participants were English-proficient adults, aged 18 years or older, with internet access and no relocation plans within 24 months.
Participants were recruited through print and broadcast media and community venues using convenience sampling.
Primary outcomes were clinically significant insomnia (Insomnia Severity Index score ≥10), elevated OSA risk (a STOP-Bang score of ≥3, measured by the following: snoring, tiredness, observed apnea, pressure, body mass index >35 [calculated as weight in kilograms divided by height in meters squared], age >50 years, neck circumference >16 in or 40 cm, and gender), and insufficient sleep duration (<7 hours per night).
Participants self-reported independent variable data including sociodemographic factors (age, sex, race, ethnicity, education, employment status, income, and living alone or with others), health indicators and behaviors (alcohol use, smoking, diet quality, physical activity, body mass index, overall health, polypharmacy [≥5 prescription medications], and use of sleep medications), and psychosocial factors (trauma, stress, anxiety or depression, and social support) via well-validated scales (eAppendix in Supplement 1).
The authors examined the bivariate association between each sleep outcome and participant characteristics using Fisher exact tests. All analyses were conducted using R version 4.2.0 (R Project for Statistical Computing) with a 2-sided P < .05 considered statistically significant.
Read More . . .
______________
Moloney ME, Slade E, Chung J, Mitu MM, Grandner MA, Moga DC. Social Determinants of Sleep Health Inequities Among Rural Appalachian Adults. JAMA Network Open. 2026;9(4):e265908. doi:10.1001/jamanetworkopen.2026.5908.
