UK gets $3.7 million grant to find out why Appalachian Kentucky is so sleep-deprived, part of 'public-health epidemic' cited by CDC

By Elizabeth Chapin
University of Kentucky

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

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 calls a "public-health epidemic."

Kentuckians are some of the nation’s most sleep-deprived, particularly in the state's Appalachian counties, where 25% to 58% of adults report insufficient sleep, defined as less than six hours a day.

Over five years, 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 Appalachian counties: six coalfield counties that have been identified as insufficient sleep hotspots (Pike, Knott, Perry, Letcher, Bell and Whitley), and six non-coal counties that are not considered hotspots (Jackson, Lincoln, Russell, Adair, Rockcastle and Estill) even though they have comparable economic distress, rurality, and demographics.

Researchers will look for 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 affects sleep.

Ph.D.s Christal Badour and Mariead Moloney

The study, titled "Researching Equitable Sleep Time in Kentucky Communities (REST-KY)," is led by Associate Professors Mairead Moloney and Christal Badour.

It aims to provide answers to longstanding questions about the causes and consequences of sleep deficiencies in rural populations, not just Appalachia. But the new knowledge will inform interventions to reduce sleep disparities among people in 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: Badour, Moloney, Suzanne Segerstrom and Lauren Whitehurst from the College of Arts and Sciences, Daniela Moga from the College of Pharmacy, Nancy Schoenberg from the College of Medicine, and Emily Slade 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,” Moloney said.

The REST-KY grant is one of NIH’s prestigious “R01” awards. It builds on the team’s previous interdisciplinary research, including a 2018 intervention study to address insomnia among women in Appalachian Kentucky.