Associations between neighborhood factors and insomnia and their spatial clustering in Philadelphia, Pennsylvania

Neighborhood-level adverse social determinants may be a risk factor for sleep health disparities. We examined the associations between neighborhood factors and insomnia and explored their spatial clustering in the city of Philadelphia, Pennsylvania. We conducted a cross-sectional analysis of data from Philadelphia residents who participated in online screening for insomnia-related research. Participants self-reported sex, age, body mass index, anxiety, post-traumatic stress disorder, depression, and insomnia symptoms. The sample was stratified as “No Insomnia” (≤7) and “Insomnia” (>7) based on the Insomnia Severity Index (range: 0-28). Neighborhood and participant data were merged using geospatial techniques. Multiple regression models and geospatial analysis were used to identify neighborhood variables that are associated with insomnia and their spatial distribution. The sample (N = 350) was predominantly female (53%), middle-aged (40.8 ± 13.8), overweight (body mass index=26.1 ± 5.54), and 53.7% had insomnia. The insomnia group had significantly higher depression scores (14.6 ± 5.5), a large percentage had anxiety (64.4%) and post-traumatic stress disorder symptoms (31.9%), and largely resided in high crime (p