This two-day course will address how epidemiologic methods can be used to study determinants and consequences of adverse sleep behaviors and characteristics and sleep disorders, and conversely, what determines/defines sleep health and how sleep health contributes to health and longevity. As defined in the book, The Social Epidemiology of Sleep, sleep epidemiology is “the study of the distribution and determinants of sleep, sleep-related symptoms, and sleep disorders and the application of this study to improve sleep health and sleep-health related conditions, including studies of how sleep influences health and disease”.

This course will provide an overview of the prevalence of sleep problems in the US population and the social and environmental determinants that contribute to sleep health disparities observed at the population level. We will discuss standard and emerging methods to study sleep health, how sleep can measured in humans by self-report and objective assessment, and the advantages and limitations of existing methodological approaches. Importantly, we will discuss multidimensional sleep health definitions and the contribution of sleep health to reducing the chronic disease burden, extending healthspan, and promoting health equity. This will be accomplished by reviewing extant and emerging literature on the role of sleep in chronic disease etiology (e.g., obesity, diabetes, cardiovascular disease, cancer, and aging outcomes).

Finally, given that sleep is a pillar of health alongside diet and physical activity, the course will also cover the interplay and bidirectional associations between these health behaviors.

By the end of the course, participants will be able to:

• Define sleep epidemiology and the concept of multidimensional sleep health.
• Identify determinants and predictors of sleep health.
• Identify and articulate various approaches to measuring sleep and circadian health.
• Describe the strengths and limitations of the various approaches to studying sleep and circadian health.
• Understand the role of sleep in preserving healthspan and associations of sleep characteristics with chronic disease and mortality.
• Review and critically assess the broad literature on sleep epidemiology and population health, including strengths and weaknesses in the conceptualization, study design, measurement, and interpretation of study findings.
• Identify knowledge gaps in the area of sleep epidemiology and research gaps pertaining to the role of sleep in health and disease across the life course.
• Understand how sleep contributes to the broader health disparities observed at the population level.

None.

1. Duncan DT, Kawachi I and Redline S. The Social Epidemiology of Sleep: Oxford University Press; 2019.
2. Buysse DJ. Sleep health: can we define it? Does it matter? Sleep. 2014;37:9-17.
3. Hale L, Troxel W, Buysse DJ. Sleep health: An opportunity for public health to address health equity. Annual review of public health. 2020 Apr 1;41:81-99.
4. Chung J, Goodman M, Huang T, Bertisch S, Redline S. Multidimensional Sleep Health: Concepts, Advances, and Implications for Research and Intervention. medRxiv. 2021 Jan 1.
5. Jackson CL, Redline S, Emmons KM. Sleep as a potential fundamental contributor to disparities in cardiovascular health. Annual review of public health. 2015 Mar 18;36:417-40.
6. St-Onge MP, Grandner MA, Brown D, Conroy MB, Jean-Louis G, Coons M, Bhatt DL. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. 2016 Nov 1;134(18):e367-86.
7. Cable J, Schernhammer E, Hanlon EC, Vetter C, Cedernaes J, Makarem N, Dashti HS, Shechter A, Depner C, Ingiosi A, Blume C. Sleep and circadian rhythms: pillars of health—a Keystone Symposia report. Annals of the New York Academy of Sciences. 2021 Aug 2.
8. Makarem N, St-Onge MP, Liao M, Lloyd-Jones DM, Aggarwal B. Association of sleep characteristics with cardiovascular health among women and differences by race/ethnicity and menopausal status: findings from the American Heart Association Go Red for Women Strategically Focused Research Network. Sleep health. 2019 Oct 1;5(5):501-8.
9. Makarem N, Alcántara C, Williams N, Bello NA, Abdalla M. Effect of Sleep Disturbances on Blood Pressure. Hypertension. 2021 Apr;77(4):1036-46.
10. Zuraikat FM, Wood RA, Barragán R, St-Onge MP. Sleep and Diet: Mounting Evidence of a Cyclical Relationship. Annual Review of Nutrition. 2021 Oct 11;41:309-32.
11. Makarem N, Aggarwal B. Gender differences in associations between insufficient sleep and cardiovascular disease risk factors and endpoints: a contemporary review. Gender and the Genome. 2017 Jun 1;1(2):80-8.

Nour Makarem, PhD

Dr. Nour Makarem is a cardiovascular epidemiologist. Her research sits at the intersection of preventive cardiology, sleep and circadian science, nutrition, and epigenetics. Dr. Makarem's interdisciplinary research program addresses the role of behavioral factors (sleep, diet, and rest-activity patterns) in cardiovascular risk and elucidates sex and ethnic differences in these relations. Her current research evaluates the contribution of sleep to cardiovascular health and cardiovascular disease risk modeling. Dr. Makarem also leads a line of research on the circadian rhythmicity of behavioral factors, which refers to their timing and regularity in the 24-h day and across days, in relation to cardiovascular risk, with a particular interest in out-of-clinic blood pressure and glycemic profiles. To develop holistic approaches to precision prevention, her work additionally examines the influence of health behaviors on epigenetic mechanisms related to aging that can alter susceptibility to cardiovascular disease. The goal of her research is to improve cardiovascular disease risk prediction and inform precision behavioral interventions to promote cardiovascular health equity, particularly among immigrant populations. Dr. Makarem's research has been funded by the National Heart, Lung, and Blood Institute and the American Heart Association. Dr. Makarem's research has been funded by the National Heart, Lung, and Blood Institute, National Institute on Minority Health and Health Disparities, and the American Heart Association