. 2019 Dec 21;157(5):1304–1312. doi: 10.1016/j.chest.2019.12.002

Table 1.

Relationship of Physical (Natural and Built), Social, Ambient, and Neighborhood Environmental Features to Sleep Outcomes

Environmental Feature	Longer Sleep Duration	↑ Efficiency/↑ Quality	Short Latency	↑OSA/BMI/AHI	Reference(s)
Natural
Water	↑				6
Green space	↑/↑^a				7, 9, 53
Built
Obesogenic	↓^a			↑/↑^a BMI	10, 11, 12, 13, 55, 56
↑ Recreation	↑^a	↑^a		↓ BMI	15, 53, 59
Urban disorder	↓	↓	↓		25, 28, 29, 30
↑ Walkability	↓			↓ AHI	18, 21
Density	↓^a			↑ OSA^a	21, 51, 52, 53, 54
Social
↑ Cohesion	↑		↑		26, 33
↑ Fragmentation	↓	↓	↓		29, 32, 33, 34
↓ Safety/↑ Violence	↓/↓^a	↓/…	↓/↓^a		25, 26, 27, 35, 36, 37, 65, 69, 70
Ambient
Artificial light			↓		41, 42, 43
Air pollution				↑ OSA	47, 48, 49, 50, 71, 72
Noise	↓	↓	↓		44, 45, 46
Neighborhood
Disadvantage ↓ SES/↑ Deprivation	↓/…/↓^a	↓/…/↓^a	…	↑ OSA^a	22, 23, 24, 25, 26, 27, 54,60, 61, 62, 63, 64, 65, 66

Obesogenic environment: ↓ street connectivity, ↓ mixed land use, and ↓ healthy food stores. ↑ = favorable effect on sleep outcomes (longer sleep duration, higher efficiency, and shorter latency), except for OSA/BMI/AHI outcome where ↑ indicates worse OSA and higher BMI and AHI; ↓ = unfavorable effect on sleep outcomes (lower sleep duration, worse efficiency and longer latency), exception of OSA/BMI/AHI where ↓ indicates less or decrease in; AHI = apnea hypopnea index.

Pediatric finding.