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Insomnia, sleep problems more common in homeless

Homeless individuals in France slept less and were more likely to report insomnia and daytime fatigue than the general population, according to recent findings.

“Sleeping less than 6 hours per night is associated with increased risk of obesity, type 2 diabetes, cardiovascular disease, depression, anxiety, pain, and accidents. Being homeless makes sleep particularly difficult,” Damien Léger, MD, PhD, of Université Paris Descartes, and colleagues wrote. “Homeless facilities are often closed at night, and homeless people face inclement weather, darkness, and fear for their personal security. Owing to limited resources, many facilities limit the number of nights per individual. Thus, many homeless persons have no regular access to a safe and warm bed at night.”

To study sleep among homeless people, researchers analyzed data from a survey conducted by the French National Institute on Statistics and Economic Studies and the Institute for Demographic Studies. The study cohort included 3,453 individuals with a mean age of 39.8 years.

At study enrollment, 197 participants were living on the street, 447were in collective short-term shelters (housing for less than 1 week), 1,320 in collective long-term shelters (housing for more than 1 month), 240 in small social services paid hotels, and 1,249 in individual facilities (one or two bedrooms for homeless persons with children).

Total sleep time among homeless participants was 6 hours and 31 minutes, compared with 7 hours and 9 minutes among the general population.

Eight percent of homeless participants reported less than 4 hours of total sleep time over the past 24 hours, compared with 3% of the general population.

Homeless women were twice as likely as men to report sleeping less than 4 hours.

Insomnia was significantly more common among homeless individuals than the general population (41% vs. 19%).

Average daytime sleep duration was 30 minutes per day among homeless participants; however, 33% reported daytime fatigue, compared with 15% of the general population.

Twenty-five percent of homeless individuals reported regularly taking a drug to help them sleep, while this was reported in 15% of the general population.

“We believe that improving sleep deserves more attention in this vulnerable group,” the researchers wrote. “We strongly support strategies other than hypnotic agents to improve sleep in the homeless, including more careful control of noise, lighting, heating, and air conditioning at night. Facilities could provide residents with sleep aids, such as earplugs, eye sleep masks, and pillows. Screens between beds could offer some sense of privacy, even in collective dormitories, and addressing issues of personal security should promote better sleep. Ideally, housing facilities would provide individual rooms, but collective shelters might be better organized with specific architecture and schedules to promote sleep.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.