# Researching Equitable Sleep Time (REST) in Appalachia

> **NIH NIH R01** · UNIVERSITY OF KENTUCKY · 2022 · $757,695

## Abstract

Insufficient sleep (habitual sleep duration of ≤6 hours), is a costly, prevalent, public health problem associated
with numerous negative health outcomes. Prior research suggests that insufficient sleep is more prevalent
among health disparity populations (e.g., racial minorities, adults of low socioeconomic status), but our
understanding of the mechanisms and consequences of sleep disparities in rural populations is limited. The
present study “Researching Equitable Sleep Time in Kentucky Communities (REST-KY),” focuses on
Appalachian adults, an NIH-designated health disparity population, whose serious health inequities include
multiple health morbidities and premature mortality. Six of the counties with the highest concentration of
insufficient sleep in the nation are in Central Appalachian Kentucky (KY), where 25-58% of adults report
insufficient sleep 15+ nights/month. These counties are severely economically distressed, yet, nearby counties
with comparable economic distress, rurality, and demographic homogeneity are not “hotspots” of insufficient
sleep. Use of a mixed methods, longitudinal design will allow us to evaluate mechanisms contributing to both
sleep deficiencies and health in this rural community. Knowledge gaps include 1) Sparse insights into specific
individual-, social-, and societal-level factors contributing to sleep deficiencies in Appalachian adults.; 2) It is not
known if regional sleep and health disparities share the same underlying mechanisms; and 3) Critical points of
variance between “hotspot” and non-“hotspot” counties have not been examined. We will recruit a cohort of 400
adults from 6 insufficient sleep “hotspot” counties (n=200) in Appalachian KY, and 6 similarly rural and
economically distressed non-“hotspot” counties. Recruitment will be stratified across “hotspot” and non-“hotspot”
counties by key demographic factors linked to sleep deficiencies (e.g., age, sex, race/ethnicity) to promote county
cluster-level comparisons. Specific Aims. 1. Use mixed methods to compare how individual, social, and societal
factors linked to sleep deficiencies differ between insufficient sleep “hotspot” and non-“hotspot” counties. 2.
Evaluate mechanisms driving sleep deficiencies and health outcomes over time. Bi-directional models of sleep
and health outcomes will be examined. 3. Quantify day-to-day sleep reactivity (i.e., the degree to which daytime
distress impacts sleep) and test if individual differences in sleep reactivity predict worsened health outcomes
over time. Differences by sex and county cluster (“hotspot” vs. non-“hotspot”) will also be examined in Aims 2-3.
Our multiple, sophisticated objective and subjective data collection methods, made possible by our
interdisciplinary team’s varied expertise, will advance scientific knowledge about biological, behavioral,
emotional, and social contributions to sleep health. This holistic approach explicitly acknowledges the
inseparable overlap between health function, and sleep....

## Key facts

- **NIH application ID:** 10495372
- **Project number:** 5R01MD016236-02
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Christal L. Badour
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $757,695
- **Award type:** 5
- **Project period:** 2021-09-26 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10495372

## Citation

> US National Institutes of Health, RePORTER application 10495372, Researching Equitable Sleep Time (REST) in Appalachia (5R01MD016236-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10495372. Licensed CC0.

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