Abstract Body (Do not enter title and authors here): Introduction: Household environmental factors and sleep behaviors may contribute to poor sleep health. We identified associations between household sleep environment (HHSE) and sleep health characteristics in White and Black adults.

Hypothesis: Individuals with adverse HHSE will have poorer sleep health.

Methods: We used cross-sectional data from the CARDIA sleep ancillary study at Year 35. HHSE was assessed in two domains (i.e., sleep disruptors and sleep behaviors) using a self-reported questionnaire (see Table footnote).The HHSE domain scores were derived from questionnaire responses, and a higher score indicated more sleep disruptors or poorer sleep behaviors. Sleep outcomes were: 1) sleep quality assessed with the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness assessed with the Epworth Sleepiness Scale (ESS) and 2) actigraphy-measured sleep duration, sleep percentage, midpoint sleep time, and sleep regularity. Robust regression estimated differences in sleep outcomes corresponding to each 1-unit increment in HHSE. Covariates were adjusted as appropriate (Table 1). Racial differences in associations of interest were examined by testing for interaction

Results: Participants’ mean age was 61.5 years, 63% were women, and 36.7% were Black. Medians (IQR) of PSQI, ESS scores, sleep duration, sleep percentage, midpoint sleep time, and sleep regularity were: 5 (4, 8), 5 (3, 7), 6.9 hours (IQR= 6.3, 7.5), 91% (IQR= 88, 93.4), 2:54 AM (IQR= 2:18, 3:42), and 0.7 hours (IQR= 0.5, 1.2), respectively. After multivariable adjustment, both more sleep disruptors and poor sleep behaviors were associated with self-reported poor sleep quality. Poor sleep behaviors were associated with actigraphy-measured shorter sleep duration and sleep irregularity. HHSE showed no association with sleep percentage and midpoint sleep time (Table 1). In stratified analysis, more sleep disruptors were associated with self-reported poor sleep quality (p-interaction= 0.027) and greater daytime sleepiness (p-interaction= 0.019) only in Black participants.

Conclusions: Adverse household sleep environment was related to subjective poor sleep quality and to objective shorter sleep duration and sleep irregularity. Future studies should investigate reasons why Black adults appear more susceptible to household sleep disruptors. Interventions to mitigate sleep disruptors and promote healthy sleep practices may help to improve sleep health.