Poor sleep is linked to a wide range of medical issues, including hypertension, diabetes, depression, obesity and cancer. With more than a third of U.S. adults reporting insufficient sleep, the Centers for Disease Control and Prevention (CDC) describes sleep deprivation as a public health epidemic.

The public health burden of sleep deprivation is especially high in Kentucky: residents are some of the nation’s most sleep-deprived, particularly in rural Appalachia where 25-58% of adults report insufficient sleep, defined as less than six hours a day.

The University of Kentucky has received a $3.7 million grant from the National Institutes of Health (NIH) to find out why people in the Appalachian region of Kentucky have such consistently poor sleep outcomes.

Led by Mairead Moloney, Ph.D., and Christal Badour, Ph.D., associate professors in the College of Arts and Sciences, "Researching Equitable Sleep Time in Kentucky Communities (REST-KY)" will provide answers to long-standing questions about the causes and consequences of sleep deficiencies in rural populations.

The new knowledge will inform interventions to reduce sleep disparities among people in rural Appalachia, who also experience severe health inequities including higher mortality rates for many conditions including diabetes, heart disease and cancer.

“Sleep is the critical pivot point for understanding ways in which people in this region experience health disparities,” said Badour. “If we can understand why people are getting poor sleep, we can then identify interventions that can help them sleep better, which would have cascading benefits for many aspects of their health.”

The REST-KY team includes experts across four UK colleges: Suzanne Segerstrom, Ph.D. and Lauren Whitehurst, Ph.D., from the College of Arts and Sciences, Daniela Moga, Ph.D., from the College of Pharmacy, Nancy Schoenberg, Ph.D. from the College of Medicine, and Emily Slade, Ph.D., from the College of Public Health.

“This collaboration of experts across so many disciplines will enable us to get a holistic look at the biological, behavioral, emotional, and social contributions to sleep health,” said Moloney.

Over the five-year study, the team will track the sleep of 400 adults from Appalachian Kentucky, along with health information such as heart rate, physical activity, blood sugar levels, and immune function. Participants will also report their daily experiences including stress and substance use.

Participants will come from 12 Kentucky counties: six that have been identified as insufficient sleep “hotspots” (Pike, Knott, Perry, Letcher, Bell and Whitley), and six that are not considered hotspots of insufficient sleep (Jackson, Lincoln, Russell, Adair, Rockcastle and Estill) – even though they have comparable economic distress, rurality, and demographics.

Results will show what drives sleep deficiencies and health outcomes over time, how factors linked to sleep deficiencies differ between hotspot and non-hotspot counties, and the degree to which daytime distress impacts sleep.

The findings will be used as a basis to develop and implement interventions to improve sleep among Appalachian Kentuckians. 

As one of the NIH’s prestigious “R01” grants, REST-KY builds upon the team’s previous interdisciplinary research, including a 2018 intervention study to address insomnia among women in Appalachian Kentucky.

That study came about thanks to UK programs intended to generate and support collaborative research.

Moloney, Badour and Moga initially connected through UK’s Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) fellowship, and their study received pilot funding through UK’s Igniting Research Collaborations program and support from UK’s Center for Clinical and Translational Science.

“The BIRCWH fellowship and the Igniting Research Collaboration grants are foundational starting points for REST-KY,” said Moloney. “The project is a testament to how internal funding programs at UK can lead to these wonderful collaborations, which generate extramural grants to support groundbreaking research.”

Research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD016236. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.