# Sleep Health in the Rural South and Its Relationships with Cardiometabolic Health Disparities

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $1,141,804

## Abstract

PROJECT SUMMARY/ABSTRACT
Rural communities in the southern U.S. suffer a disproportionate burden of morbidity and mortality from
cardiometabolic disease, with traditional risk factors explaining only a modest proportion of the excess burden
of disease. Growing evidence implicates poor sleep health as an important risk factor for cardiometabolic
disease. While this is most well established for sleep apnea and insomnia, there is considerable evidence that
multiple dimensions of sleep health, including sleep duration, efficiency, timing, and regularity, also affect
cardiometabolic disease risk. Moreover, rural Southern communities are likely to experience high rates of
impaired sleep health, reflecting high levels of psychosocial and environmental stressors, such as financial
stress, social isolation, environmental pollution, and poor built environment in addition to high rates of smoking
and obesity. However, there is currently a lack of systematically developed sleep data in rural populations.
Recognizing the paucity of research on cardiometabolic risk in this high-risk rural population, the NHLBI
recently initiated a new longitudinal epidemiology study in rural Appalachia and Mississippi Delta (the RURAL
Study) to identify the complex individual, social and environmental factors contributing to this high burden of
disease. The proposed RURAL Sleep Study will complement the RURAL Study by incorporating minimally
burdensome measures of multiple dimensions of sleep health at the time of baseline cohort assessment in
approximately 4000 adults age 25-64 years, utilizing mobile health technologies to (a) measure sleep apnea
over 4 consecutive nights; (b) measure sleep duration, timing, regularity and fragmentation over multiple
weeks; and (c) administer standardized questionnaires to assess insomnia, chronotype, sleep quality and
sleep-related impairment. These data will allow us to leverage the planned extensive assessments of
cardiometabolic risk factors, subclinical disease, and psychosocial and environmental stressors (and resilience
factors) to address the following specific aims:
Aim 1a. Quantify population distributions of sleep health measures in a rural cohort along dimensions of sleep
apnea, insomnia, chronotype, and sleep duration, efficiency, timing, and regularity.
Aim 1b. Identify psychosocial, behavioral, and environmental correlates of sleep health in rural communities.
Aim 2. Assess the association of sleep health with cardiometabolic risk factors and subclinical cardiovascular
disease independent of other established cardiovascular and metabolic risk factors.
The results are expected to inform health care providers, public health officials, and the general public of the
prevalence, risk factors, and consequences of impaired sleep health in these rural communities, providing a
critical basis for prevention, recognition, and management of sleep disorders and improvement of sleep and
cardiometabolic health.

## Key facts

- **NIH application ID:** 10906851
- **Project number:** 5R01HL164462-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Daniel J Gottlieb
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,141,804
- **Award type:** 5
- **Project period:** 2023-08-15 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10906851

## Citation

> US National Institutes of Health, RePORTER application 10906851, Sleep Health in the Rural South and Its Relationships with Cardiometabolic Health Disparities (5R01HL164462-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10906851. Licensed CC0.

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